外伤性颅脑出血患者术后继发肺部感染的危险因素分析_赵鹏飞.pdf

2023 年 2 月第 30 卷第 2 期外伤性颅脑出血患者术后继发肺部感染的危险因素分析赵鹏飞，王天才*（河南大学附属南石医院 重症医学科，河南 南阳473010）【摘要】目的 探讨外伤性颅脑出血患者术后继发肺部感染的危险因素。方法60例外伤性颅脑出血患者根据术后肺部感染发生情况分为感染组和未感染组，分析术后肺部感染的危险因素，并构建预测模型。结果单因素及多因素Logistic回归分析显示，留置胃管、术前GCS评分低、WBC高、机械通气时间长是术后肺部感染的危险因素（P 005）。上述四项指标联合预测外伤性颅脑出血患者术后肺部感染的AUC、灵敏度、特异性分别为0902、9000、9400。结论留置胃管、术前GCS评分低、WBC高、机械通气时间长是外伤性颅脑出血患者术后肺部感染的危险因素，利用上述指标构建模型预测肺部感染的价值较高。【关键词】外伤性颅脑出血；肺部感染；危险因素；预测模型中图分类号：R619+.3文献标识码：Adoi:10.3969/j.issn.1674-4659.2023.02.0287Analysis on the Risk Factors of Postoperative Pulmonary Infection in Patients with Traumatic Craniocerebral HemorrhageZHAO Pengfei,WANG Tiancai*(Department of Critical Care Medicine,Nanshi Hospital Affiliated to Henan University,Nanyang473010,China;*Corresponding author:WANG Tiancai,E-mail:)AbstractObjectiveTo explore the risk factors of postoperative pulmonary infection in patients with traumatic craniocerebralhemorrhage.Methods 60 patients with traumatic craniocerebral hemorrhage were divided into infection group and non-infection groupaccording to the occurrence of postoperative pulmonary infection.The risk factors of postoperative pulmonary infection were analyzed,andthe prediction model was constructed.ResultsUnivariate analysis and multivariate Logistic regression analysis showed that indwellinggastric tube,low preoperative GCS score,high WBC and long mechanical ventilation time were risk factors of postoperative pulmonaryinfection(P 606（60.00）18（36.00）糖尿病病史3（30.00）8（16.00）1.7980.180心脏病史2（20.00）11（22.00）0.0200.889ASA分级级1（10.00）6（12.00）2.8570.414级2（20.00）18（36.00）级2（20.00）14（28.00）级5（50.00）12（24.00）气管切开8（80.00）13（26.00）10.6810.001留置胃管4（40.00）6（12.00）4.7040.030体质量指数（kg/m2）25.614.3625.573.340.0330.974术前GCS评分（分）6.472.5112.342.816.1270.001PLT（109/L）226.711.64227.311.421.1890.239Hb（g/L）143.975.03143.125.760.4340.666APTT（s）29.123.6429.163.700.0310.975WBC（109/L）13.461.6711.941.922.3300.023MAP（mmHg）121.292.30121.222.370.0850.932麻醉时间（h）5.190.425.140.400.3580.722机械通气时间（d）2.740.512.450.262.6820.010住院时间（d）19.842.4519.892.480.0580.954表2术后肺部感染的多因素Logistic回归分析结果因素SEWald值POR95%CI留置胃管0.8380.3605.5290.0012.3241.1703.544术前GCS评分0.8700.3396.5510.0012.3971.7555.430WBC0.5390.2315.5710.0311.7111.3284.459机械通气时间1.4710.42911.8870.0014.3442.6387.740常量-3.5900.48156.1970.0890.031-图1外伤性脑出血患者术后肺部感染的预测ROC曲线（责任编辑：张普）288