ABSTRACT
Objective:To analyze the risk factors of hospital-acquired pneumonia (HAP) after craniocerebral trauma.Methods:A total of 329 patients undergoing craniocerebral trauma surgery from December 2014 to December 2019 in Yicheng People′s Hospital of Zaozhuang City were enrolled. The data were reviewed and divided into HAP group (42 patients) and non-HAP group (287 patients) according to whether HAP occurred after surgery. The age, onset to operation time, surgery duration, and hospital stay between the two groups were compared. The differences of preoperative factors, intraoperative factors and postoperative factors between the two groups were compared. The risk factors of HAP after craniocerebral trauma were analyzed by Logistic multi-factor regression analysis.Results:The age, onset to operation time, surgery duration, hospital stay in HAP group were longer than those in the non-HAP group: (55.09 ± 8.14) years vs. (45.98 ± 8.06) years, (9.65 ± 0.54) h vs. (7.43 ± 0.72) h, (332.54 ± 72.65 )min vs. (281.09 ± 78.54) min, (17.13 ± 2.56) d vs. (5.02 ± 3.09), the differences were statistically significant ( P<0.05). The differences in the types of brain diseases between the two groups were statistically significant ( P<0.05). The results of single factor analysis showed that the history of pulmonary disease, scores of Glasgow Coma Scale (GCS) < 8 points and ≥8 points, whether or not emergency operation, preoperatie antibiotics, reintubated, endotracheal intubation, indwelling gastric tube, and raise the head of a bed 30° to 45°, proton pump inhibitors, craniocerebral trauma and non traumatic diseases, mechanical ventilation, floor nutrition start time, giving glucocorticoid between the HAP group and non-HAP group had significant difference ( P<0.05). The Logistic multi-factor regression analysis showed that the age >50 years old, surgery duration >4 h, preoperative GCS<8 points, emergency surgery, tracheotomy and indwelling gastric tube were independent risk factors of HAP after surgery ( P<0.05). Conclusions:For patients undergoing surgical treatment of craniocerebral trauma, it is necessary to estimate the risk of postoperative HAP based on age, preoperative GCS score, elective surgery after emergency, operation time, and control risk factors.
ABSTRACT
Objective To compare the effect of minimally invasive hematoma the quenching aspiration and hematoma evacuation in the treatment of hypertensive basal ganglia brain hemorrhage.Methods 92 patients with hypertensive cerebral basal ganglia hemorrhage underwent surgical treatment were randomly divided into two groups:minimally invasive quenching suction group of 46 patients,craniotomy group of 46 patients.The mortality,complications and activities of daily living(ADL) postoperative three months were observed.Results The mortality rate of the minimally invasive quenching suck group was lower than that of the craniotomy group (8.7％ vs 21.7％,P ＜ 0.05).The postoperative rebleeding and the incidence rate of complications such as lung infections in the minimally invasive quenching suction group were lower than those of the craniotomy group(all P ＜ 0.05).ADL score 3 months postoperatively of the minimally invasive quenching suction group was higher than that of the craniotomy group [(85.53 ± 13.47) points vs (56.12 ± 11.72) points,P ＜ 0.05].Conclusion Minimally invasive hematoma the quenched aspiration in treatment of hypertensive basal ganglia brain bleeding trauma can reduce the mortality,reduce the occurrence of postoperative complications,increase quality of life in patients,has better efficacy for treatment of hypertensive intracerebral hemorrhage.