| Objective:Through the statistical analysis of the data of patients with craniocerebral trauma who received neurosurgery in our hospital in the past 2 years,the risk factors for postoperative hospital acquired pneumonia(HAP)in patients with craniocerebral trauma were explored.Effective prevention of traumatic postoperative pneumonia,improve the surgical effect and long-term efficacy of this type of patient to provide reference.Methods:Retrospective analysis of the clinical data of 658 patients with craniocerebral trauma emergency or elective craniotomy who were admitted to the Department of Neurosurgery,the Second Hospital of Shanxi Medical University from January 2015 to December 2017.The age and sex of the patients may cause postoperative pulmonary infection.History of smoking,onset to operation time,lung lesions(chronic obstructive lung,pulmonary contusion),preoperative GCS score,emergency surgery,preoperative use of antibiotics,percentage of neutrophils,duration of surgery,tracheotomy,tracheal intubation Intubation,indwelling gastric tube,postoperative bedside elevation(30-45 °),proton pump inhibitors,and length of hospital stay may be used to statistically analyze the factors associated with postoperative pulmonary infection to identify the ultimate independent risk Factors,including the use of independent sample T test for the measurement of age,onset to operation time and other measurement data,using the chi-square test for sex,smoking history and other count data for the final selection of thesingle factor analysis and meaningful variables for multiple factors Logistic regression analysis.Results:Among the 658 patients who were admitted to the group with surgery,aged 5 to 86 years old,372(56.53%)were males with an average age of 46.3 ± 16.4 years;286(43.47%)were females,and the average age was 47.25 ± 15.35 years;postoperative pneumonia occurred.In 95 cases,the incidence was 14.44%.After active treatment,87 cases of pneumonia patients were discharged after effective control,and 8 patients died.Univariate analysis found age(years),duration of surgery(min),total length of hospital stay,percentage of preoperative neutrophils,preoperative lung lesions(chronic obstructive lung,traumatic lung contusion),preoperative GCS score,emergency surgery,preoperative The use of antibiotics,tracheotomy,endotracheal intubation,indwelling gastric tube,postoperative bedside elevation(30-45°),and proton pump inhibitors all affected postoperative pneumonia.Multivariate logistic regression analyses revealed that independent risk factors for postoperative pulmonary infection included age(years),preoperative GCS score,emergency surgery,duration of surgery(min),tracheotomy,and indwelling gastric tube.Conclusion:The postoperative craniocerebral trauma patients are susceptible to postoperative pneumonia due to multiple factors such as the body’s own factors and hospital environment factors,including age(years),duration of surgery(min),total length of hospital stay,percentage of preoperative neutrophils,and preoperative lung Lesion(COPD,traumatic pulmonary contusion),preoperative GCS score,emergency surgery,preoperative use of antibiotics,tracheotomy,tracheal intubation,indwelling gastric tube,postoperative bedside elevation(30-45°),Proton pump inhibitors and other factors play a role in the pathogenesis,but the analysis found that HAP independent risk factorsinclude: age(years),preoperative GCS score,emergency surgery,duration of surgery(min),tracheotomy,Indwelling gastric tube should be targeted to carry out overall control of the above-mentioned independent risk factors that may trigger postoperative pneumonia,strengthen preoperative evaluation,intraoperative aseptic operation,and postoperative care in order to reduce the incidence of pneumonia and improve the surgical outcome,reduce patient hospitalization costs. |
