分析神经外科重症监护室（NICU）急性自发性脑出血患者行急诊开颅血肿清除术后罹患医院获得性肺炎（HAP）的危险性因素。

回顾性分析四川省人民医院NICU自2016年1月至2021年6月收治的207例急性自发性脑出血行急诊开颅血肿清除术患者的临床资料，根据术后是否罹患HAP，分为感染组和非感染组。采用多因素Logistic回归分析筛选NICU自发性脑出血患者急诊开颅术后HAP的独立危险因素。

本组患者中，感染组127例，非感染组80例。2组患者的年龄、术前白蛋白、术前血糖、高血压病、入院GCS评分≤8分、手术时长、术后机械通气比较，差异有统计学意义（P<0.05）。将P<0.1的因素纳入多因素Logistic回归分析，结果显示入院GCS评分≤8分、手术时长≥240 min（4 h）、术后机械通气、术前血糖≥10 mmol/L及术前白蛋白<42.5 g/L是NICU自发性脑出血患者急诊开颅血肿清除术后罹患HAP的独立危险因素。

NICU自发性脑出血患者急诊开颅血肿清除术后罹患HAP的独立危险因素有入院GCS评分≤8分、手术时长≥4 h、术后机械通气、术前血糖≥10.0 mmol/L及术前白蛋白<42.5 g/L，早期筛查并采取相应的防治措施，有助于降低术后HAP的发生率，改善远期预后。

To explore the independent influencing factors of hospital-acquired pneumonia (HAP) in Neurosurgical Intensive Care Unit (NICU) after emergency craniotomy for acute spontaneous cerebral hemotoma removal, as to provide important reference data for clinic.

The medical record data of 207 enrolled patients with emergency craniotomy for acute spontaneous cerebral hematoma removal in NICU of Sichuan Provincial People's Hospital from January 2016 to June 2021 were retrospectively analyzed. According to the patients with acute spontaneous intracerebral hemorrhage in NICU, whether they had hospital-acquired pneumonia after emergency craniotomy and hematoma removal, they were divided into infection group and non-infection group. Multiple Logistic regression analysis was used to screen for independent risk factors for HAP in NICU patients with spontaneous intracerebral hemorrhage after emergency craniotomy.

Of the patients enrolled in this study, 127 cases were in the infection group and 80 cases in the non-infection group. There were significant differences between patients in infection and non-infection groups in age, GCS score≤8 on admission, preoperative blood glucose, preoperative albumin, hypertension, operation duration, and postoperative mechanical ventilation. The factors with P<0.1 were included in the multivariate Logstic regression analysis, and the results showed that those with GCS score≤8 on admission, operation duration ≥240 min (4 h), postoperative mechanical ventilation, preoperative blood glucose≥10.0 mmol/L, and preoperative albumin<42.5 g/L were the independent risk factors for HAP in patients with spontaneous intracerebral hemorrhage undergoing emergency craniotomy and hematoma evacuation in NICU.

The independent risk factors for HAP in patients with spontaneous intracerebral hemorrhage undergoing emergency craniotomy and hematoma evacuation in NICU include admission GCS score ≤8, operation duration ≥4 h, postoperative mechanical ventilation, preoperative blood glucose ≥10.0 mmol/L, and preoperative albumin <42.5 g/L. Early screening and corresponding prevention and treatment measures can help reduce the incidence of postoperative HAP and improve long-term prognosis.