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Objective:To investigate the distribution of respiratory pathogens and risk factors of death in patients with pulmonary infection in neurosurgical intensive care unit (NICU).Methods:A total of 87 patients with pulmonary infection in the NICU of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from January 2018 to December 2019 were collected, and the pathogens of their respiratory tract were analyzed to understand the types and distribution of bacteria in the lung infection. Univariate statistical analysis was used to analyze the relationship between the patient′s clinical outcome with age, diabetes, hypertension, renal insufficiency, hypoproteinemia, anemia, chronic respiratory disease, surgery, tracheotomy, and bacterial multi-resistance. Binary logistic regression analysis was used to analyze the influencing factors of death in NICU patients with pulmonary infection.Results:A total of 112 pathogenic bacteria were isolated in this research group, including 83 Gram-negative bacteria (74.11%), 22 Gram-positive bacteria (19.64%), and 7 Fungi (5.25%). Imipenem was highly sensitive to Gram-negative bacteria, vancomycin was highly sensitive to Gram-positive bacteria, and other drugs were highly resistant. 41 patients died (47.13%). Age≥60 ( OR=3.501, 95% CI: 1.152-10.638), renal insufficiency ( OR=3.872, 95% CI: 1.336-11.224), tracheotomy ( OR=0.317, 95% CI: 0.114-0.882), bacteria multi-drug resistance ( OR=3.480, 95% CI: 1.162-10.422) were independent risk factors for death in NICU patients with pulmonary infection. Conclusions:Patients with severe neurological diseases are in critical condition, and there are many patients with pulmonary infection, with poor prognosis and high mortality. Gram-negative bacteria are the most common respiratory pathogens. Carbapenems account for the highest proportion of antibiotics in clinic. Advanced age, renal insufficiency and bacterial multidrug resistance increase the mortality of patients, while early tracheotomy can reduce the mortality of patients.
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Objective To investigate the effects of a traditional Chinese medicine (TCM ) decoction on cognitive dysfunction complicated with pulmonary infection after traumatic brain injury . Methods From February 2016 to March 2017 ,80 patients with cognitive dysfunction after traumatic brain injury ,who also had lung infection at admission to our hospital ,were enrolled and randomly divided into a control group and an observation group ,with 40 cases in each. Patients in the control group received conventional treatment with antibiotics and donepezil ,and patients in the observation group were administered a TCM decoction in addition to what was given to the control group.Mini-mental state examination(MMSE)scores and pulmonary symptom scores before and after treatment as well as adverse reactions were compared between the two groups. Results After treatment ,MMSE scores were higher in the observation group than in the control group (23.88 ± 5.90 vs.20.11 ± 6.37 ,t=2.746 ,P=0.007) ,and pulmonary symptom scores were lower in the observation group than in the control group (4.39 ± 2.01 vs.6.13 ± 2.24 ,t = 3.656 ,P = 0.007 ). The total incidence of adverse reactions showed no significant difference between the two groups (P＞0.05). Conclusions The TCM decoction has clear benefits and high safety in treating cognitive impairment complicated with pulmonary infection after brain injury. It can improve cognitive ability and clinical symptoms of the lungs ,and should be recommended.