Risk Factors Analysis Of Pulmonary Infection In Postoperative Patients With Hypertension Cerebral Hemorrhage

BackgroundThe postoperative patients with hypertension cerebral hemorrhage have a week condition because of the strike from damage of the central nervous system and ope ration.Further more,the indwelling catheter became a potential approach to infectio n after the operation.Therefore,the postoperative patients have a high incidence of pulmonary infection.The studies of pulmonary infection after stroke consist of clin ical features and related factors.But those studies have more focuses on patients wit h nonoperative treatment,and have few attention on postoperative patients.And tho se studies have no common view about related factors of pulmonary infection in po stoperative patients.So we still have poor theoretical basis and guidance of preventi on and treatment of pulmonary infection in postoperative patients with hypertension cerebral hemorrhage.ObjectiveTo analyze the risk factors of pulmonary infection in postoperative patients with hypertension cerebral hemorrhage.Methods213 cases of postoperative patients with hypertensive cerebral hemorrhage wer e selected to be retrospectively analyzed,who were treated in the neurosurgical dep artment of the First Affiliated Hospital from January 2015 to June 2016.They wer e divided into infection group and control group according to whether gotpulmonary infection.We regest 14 clinical datas of those patient.Which were independent va riables.Including age,smoking history,chronic obstructive pulmonary disease,diabetes,heart disease,vomiting before operation,glasgow coma scale before operation,location of hematoma,whether the hemorrhage bursts into ventricals of the brain,time of tracheal intubation,tracheotomy,time of mechanical ventilation,time of ind welling nasogastric tube,hypoproteinemia.The dependent variable was whether deve loped pulmonary infection or not.Univariate analysis was performed on 14 clinical datas one by one.Then the datas whose difference had statistically significant were made multivariate Logistic regression analysis.All those prosess were conduct by SPSS19.0,and take P < 0.05 for statistical significance.Results1.147 cases of 213 postoperative patients with hypertensive intracerebral hemorr hage developed pulmonary infection,and the infection rate was 69.01%.There were74 species of bacteria were found by sputum culturing,including 26 klebsiella pne umoniae(21.62%),16 baumanii(16.22%),6 pseudomonas aeruginosa(8.11%),6 escher ichia coli(8.11%),4 streptococcus pneumoniae(5.41%),1 haemophilus influenzae,1 enterobacter cloacae,1 serratia marcescens,1 monilia.2.The single factor regression analysis showed that 10 factors were statistically significant(P < 0.05).Including smoking history,chronic obstructive pulmonary di sease,vomiting before operation,glasgow coma scale before operation,location of hematoma,time of tracheal intubation,tracheotomy,time of mechanical ventilation,time of indwelling nasogastric tube,time of indwelling nasogastric tube,hypoprotein emia.3.Multivariate Logistic regression analysis showed that 6 factors had significant influence on the development of postoperative pulmonary infection.Including glasg ow coma scale before operation(OR 1.680,95%CI 1.098~2.569),time of tracheal intubation(OR 2.897,95%CI 1.678~5.002),time of mechanical ventilation(OR 6.324,95%CI 3.539~11.300),location of hematoma(OR 0.614,95%CI 0.384~0.983),hypoproteinemia(OR 4.540,95%CI 1.351~15.248),time of indwelling nasogastric tube(OR 1.549,95%CI 1.330~1.804).Conclusion:The rate of pulmonary infection of postoperative patients with hypertensive intr acerebral hemorrhage was 69.01%.We found that six factors were independent risk factors of the pulmonary infection by statistical analysis.There were Including glas gow coma scale before operation,time of tracheal intubation,time of mechanical ve ntilation,location of hematoma,hypoproteinemia,time of indwelling nasogastric tube.