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目的探讨危重病人肺部二重感染的相关因素及防治对策。方法对APACHEⅡ评分>12分的326例危重病人中发生肺部二重感染的21例患者进行相关危险因素的统计分析。结果原发病严重、高龄、营养不良是患者自身的危险因素;治疗中可能引起肺部感染的因素如手术、人工气道或机械通气及时间长短、广谱抗生素和糖皮质激素的应用、应激性高血糖等均是引起肺部二重感染的医源性危险因素。结论加强对高龄患者的监测,迅速、合理处理原发性及应激性高血糖,加强营养支持,确切掌握人工气道、机械通气应用指征及尽早脱机,合理应用抗生素及激素是防治二重感染的关键。
Objective To explore the related factors and prevention and cure measures of pulmonary double infection in critically ill patients. Methods Twenty-one patients with COPD in 326 critically ill patients with APACHEⅡ score> 12 were analyzed statistically. The results of the primary disease is serious, elderly, malnutrition is the patient’s own risk factors; treatment may cause lung infection factors such as surgery, artificial airway or mechanical ventilation and the length of time, broad-spectrum antibiotics and glucocorticoid application should Irritable hyperglycemia and so on are the iatrogenic risk factors that cause double infection in the lungs. Conclusion To strengthen the monitoring of elderly patients, rapid and rational treatment of primary and stress hyperglycemia, enhance nutritional support, accurate grasp of artificial airway, mechanical ventilation indications and as soon as possible offline, rational use of antibiotics and hormones is the prevention and treatment of two The key to infection.