口腔颌面外科患者气管切开术后肺部感染的病原学分析及干预对策

发布时间：2018-04-10 11:30

本文选题：口腔颌面外科 + 气管切开术　；参考：《中华医院感染学杂志》2014年05期

【摘要】：目的探讨分析口腔颌面外科患者气管切开术后肺部感染的病原学及干预对策,为临床合理使用抗菌药物提供依据。方法回顾性分析医院2007年4月-2013年3月58例行口腔颌面外科气管切开术后肺部感染患者的临床资料,并对患者的痰液进行病原菌培养及药敏试验,同时进行耐药菌检测。结果 58例肺部感染患者送检标本共培养出病原菌120株,其中革兰阴性杆菌占71.7%,革兰阳性球菌占24.2%,真菌占4.2%;前5位的病原菌依次为铜绿假单胞菌、鲍氏不动杆菌、金黄色葡萄球群、肺炎克雷伯菌、大肠埃希菌,分别占10.8%、25.3%、20.0%、13.3%、12.5%;铜绿假单胞菌、鲍氏不动杆菌、肺炎克雷伯菌对氨苄西林的耐药率均为100.0%,对头孢唑林、头孢呋辛的耐药率均70.0%;金黄色葡萄球菌、表皮葡萄球菌对青霉素、氨苄西林、哌拉西林的耐药率均80.0%,未发现耐万古霉素菌株。结论口腔颌面外科气管切开术后肺部感染以革兰阴性杆菌多见,且耐药性高,采取综合措施加强呼吸道管理、根据培养及药敏结果合理使用抗菌药物,给予临床干预利于肺部感染控制。
[Abstract]:Objective to investigate the etiology and intervention of pulmonary infection after tracheotomy in oral and maxillofacial surgery patients.Methods the clinical data of 58 patients with pulmonary infection after tracheotomy in oral and maxillofacial surgery from April 2007 to March 2013 were retrospectively analyzed.The resistance rates of Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae to ampicillin were 100.0and cefazolin, respectively.The resistance rates of cefuroxime to cefuroxime were 70.0.Staphylococcus aureus, Staphylococcus epidermidis were resistant to penicillin, ampicillin and piperacillin, and no vancomycin resistant strains were found.Conclusion Gram-negative bacilli are common in pulmonary infection after tracheotomy in oral and maxillofacial surgery, and the drug resistance is high. Comprehensive measures should be taken to strengthen the management of respiratory tract, and antibiotics should be used reasonably according to the results of culture and drug sensitivity.Clinical intervention is beneficial to the control of pulmonary infection.
【作者单位】：河北医科大学第四医院口泌病区;广东医学院附属医院骨科;
【基金】：广东省湛江市科技局基金项目(2012C3102026)
【分类号】：R563.1

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