探讨重型颅脑损伤（sTBI）并发肺部感染的临床特点。

回顾性分析空军军医大学第一附属医院神经外科重症监护室（ICU）自2011年3月至2020年10月收治的520例sTBI患者的临床资料。根据患者痰培养结果及临床诊断统计患有肺部感染的人数及感染菌种，重点分析优势菌种及其在2011~2020年的变化规律，以及混合感染及单菌种感染对患者住院时长的影响。

520例sTBI患者中，212例（40.8%）患有肺部感染，菌种依次以鲍曼不动杆菌、铜绿假单胞菌、耐甲氧西林金黄色葡萄球菌（MRSA）和肺炎克雷伯菌为主，其中MRSA和肺炎克雷伯菌近年来占比有所上升，有成为优势菌种的趋势。合并肺部感染患者住院时长显著长于未合并肺部感染的患者（Z=-13.127，P<0.001），且混合感染患者住院时长显著长于单菌种感染患者（Z=-6.919，P<0.001）。

ICU中sTBI患者肺部感染的菌种及变化可能与医疗环境卫生密切相关，且合并肺部感染特别是混合感染会显著延长患者的住院时长。

To investigate the clinical characteristics of patients with severe traumatic brain injury (sTBI) complicated with pulmonary infection.

Five hundred and twenty patients patients with sTBI treated in Neurosurgery Intensive Care Unit (ICU) of the First Affiliated Hospital, Air Force Military Medical University from March 2011 to October 2020 were analyzed retrospectively. According to the results of sputum culture and clinical diagnosis, the number of patients with pulmonary infection and infection strains were counted, and focus on the analysis of the dominant strains and their change rules from 2011 to 2020, as well as the impact of mixed infection and single-strain infection for hospital duration.

Among the 520 patients with sTBI, 212 patients (40.8%) had lung infections. The strains consist mainly of Acinetobacter baumannii, Pseudomonas aeruginosa, meth-resistant Staphylococcus aureus (MRSA) and Klebsiella pneumoniae. The proportion of MRSA and Klebsiella pneumoniae has increased in recent years, and has a tendency to become dominant strains. The patients with pulmonary infection were hospitalized significantly longer than patients without pulmonary infection (Z=-13.127, P<0.001), and the hospital duration with mixed infection was remarkably longer than that with single-strain infection (Z=-6.919, P<0.001).

The strains and changes of pulmonary infections in patients with sTBI in ICU may be closely related to medical environmental health care, in addition, combined pulmonary infections, especially mixed infections, can significantly prolong the length of hospitalization.