非重症肺挫伤患者预后危险因素分析

Analysis of Prognostic Risk Factors in Patients with Nonsevere Pulmonary Contusion

摘要: 目的：探究预防性抗生素使用对胸部钝挫伤后非重症肺挫伤患者的疗效，分析该类伤患发生肺部感染的危险因素。方法：纳入2022年9月至2023年5月在福建中医药大学附属第二人民医院急诊科就诊的胸部钝挫伤后非重症肺挫伤患者60例，按照随机数表法分为研究组(30例)和对照组(30例)，对照组予镇痛等常规治疗，研究组在常规治疗的同时加予预防性抗生素治疗，记录两组的肺部感染情况。再将所有纳入患者以是否发生肺部感染分为感染组和未感染组，对预后的相关危险因素进行单因素及多因素分析。结果：研究组剔除2例，对照组剔除1例，均为自愿退出。两组基线资料比较均无统计学差异(P > 0.05)，肺部感染发生率亦无统计学差异(P > 0.05)。多因素分析表明吸烟史(OR = 41.225, P < 0.01)、肋骨骨折根数(OR = 1.623, P < 0.05)是影响肺部感染的独立危险因素。结论：抗生素的预防性用药并不能减少非重症肺挫伤患者肺部感染的发生，吸烟史及肋骨骨折根数是发生肺部感染的独立危险因素。

Abstract: Objective: To explore the efficacy of prophylactic antibiotics in patients with nonsevere pulmonary contusion after blunt chest trauma and analyze the risk factors for pulmonary infection in patients with such injuries. Methods: 60 patients with nonsevere pulmonary contusion after blunt chest trauma who visited the emergency department of the Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine from September 2022 to May 2023 were included. They were randomized into two groups. The both group received conventional treatment such as analgesia, and the intervention group added antibiotic prophylaxis at the same time. The pulmonary infection of the two groups were recorded. Then all included patients were divided into infection group and non-infection group based on whether they had pulmonary infection. Monofactor analysis and multivariate analysis were performed on the relevant risk factors for prognosis. Results: There was no statistical difference in the baseline data between intervention group and control group (P > 0.05), and there was also no statistical difference in the incidence of pulmonary infection between two groups group (P > 0.05). Multivariate analysis showed that smoking history (OR = 41.225, P < 0.01) and number of rib fractures (OR = 1.623, P < 0.05) were independent risk factors for pulmonary infection. Conclusions: Antibiotic prophylaxis cannot reduce the occurrence of pulmonary infection in patients with nonsevere pulmonary contusion. Smoking history and the number of rib fractures are independent risk factors for the occurrence of pulmonary infection in patients with such injuries.