A Study On The Related Factors Of Postoperative Pneumonia In Elderly Patients Undergoing Craniocerebral Selective Surgery

Objective:To investigate the risk factors of pulmonary infection in elderly patients undergoing elective craniocerebral surgery,and to provide evidence for effective prevention and control of infection.The purpose of this study is to promote the attention of the elderly patients undergoing craniocerebral surgery,and to prevent the occurrence of postoperative pulmonary infection or to detect the occurrence of postoperative pulmonary infection as early as possible,which will provide some reference guidance for clinical work.Methods:The elderly patients from January 2015 to June 2016 underwent Department of Neurosurgery craniocerebral elective surgery from Shanghai Tenth People's Hospital Affiliated to Tongji University,the retrospective survey method,hospital medical inspection survey,record survey(1)general information: name,gender,age,hospital number,admission diagnosis,preoperative medical history;(2): catheter indwelling nasogastric tube,urinary tract intubation,airway intubation or tracheostomy;(3)operation: whether two operation,operation time,anesthesia,GCS score;(4)infection include: the occurrence of infection,infection time,pathogen detection;(5)nutrition situation: the level of serum albumin and NRS-2002 scores in the unified questionnaire.Results:1.75 years of age or older,gender,chronic obstructive pulmonary disease history,operation time was 2h,general anesthesia intubation or tracheostomy,respiratory tract,serum albumin < 35g/L,GCS score,NRS-2002 score more than 3 severe coma is independently associated with pulmonary infection after craniocerebral elective surgery.The P values of 2 factors in diabetes and two operations were all >0.05,which indicated that there was no significant difference between these factors.2.The average length of stay(62.83±39.21)in the infection group was two times that of the uninfected group(30.20±17.47),and there was a significant difference(P <0.01).Prognosis: there were 1 deaths in the infection group,and 5 patients were discharged from the hospital,so the overall prognosis was poor.The infection rate was 16.67%,which was much higher than that of the uninfected group 4.08%(P<0.01),and the prognosis was lower in the infection group than in the uninfected group(P<0.01).3.36 cases of infection,including 27 cases of lung biology culture detected pathogenic bacteria,the detection rate was 75%,5 patients were detected at the same time two kinds of flora.The pathogenic bacteria are gram positive bacteria,gram negative bacteria and fungi.Pathogenic bacteria dominated by bacteria,among which gram negative bacteria were the most common.In this study,25 cases were detected,accounting for 78.13% of all detected bacteria.There were 1 cases of Candida albicans fungal infection.Of all pathogenic bacteria,Klebsiella pneumoniae was the highest detectable rate,accounting for 28.11%.Conclusion:In summary,postoperative pulmonary infection involves many predisposing factors and prevention from the patients after admission,timely analysis and treatment for patients with unfavorable factors exist;we should strengthen the aseptic concept and ward management,good respiratory nursing work;standardize the use of antimicrobial.Once the infection symptoms,early sputum culture,after a clear pathogen,you can turn from empirical treatment to targeted treatment to improve efficacy.