食管癌患者气管插管全麻术后肺部感染的病原菌分布与危险因素分析

发布时间：2018-07-08 18:33

本文选题：食管癌 + 肺部感染　；参考：《中华医院感染学杂志》2015年19期

【摘要】：目的对食管癌(EC)患者气管插管全麻术后肺部感染的病原菌分布及危险因素进行分析,为肺部感染预防控制提供依据。方法选择2012年8月-2015年2月在医院接受气管插管全麻手术治疗的770例EC患者进行研究,对发生肺部感染的80例EC患者临床资料进行回顾性分析,分析术后发生肺部感染患者的病原菌分布特点以及其危险因素。结果 770例患者发生肺部感染80例,感染率10.4%;共分离出病原菌83株,其中革兰阴性菌56株占67.8%,革兰阳性菌22株占26.2%,真菌5株占6.0%;单因素分析显示,年龄60岁、有长期吸烟史、无术后镇痛和术后气管导管留置时间2h是EC患者术后发生肺部感染的危险因素,差异有统计学意义(P0.05);多因素回归分析显示,年龄、长期吸烟史、术后气管导管留置时间是EC患者发生肺部感染的独立危险因素。结论 EC患者气管插管全麻术后肺部感染病原菌以革兰阴性菌为主,肺部感染的发生与年龄、长期吸烟史、术后气管导管留置时间密切相关。
[Abstract]:Objective to analyze the pathogenic bacteria distribution and risk factors of pulmonary infection after tracheal intubation in patients with esophageal carcinoma (EC), so as to provide evidence for prevention and control of pulmonary infection. Methods from August 2012 to February 2015, 770 patients with EC underwent general anesthesia with tracheal intubation. The clinical data of 80 patients with pulmonary infection were retrospectively analyzed. The distribution and risk factors of pathogenic bacteria in postoperative patients with pulmonary infection were analyzed. Results there were 80 cases of pulmonary infection (10.4%) in 770 patients, 83 strains of pathogenic bacteria were isolated, 56 strains of Gram-negative bacteria accounted for 67.8, 22 strains of Gram-positive bacteria accounted for 26.2% and 5 strains of fungi accounted for 6.0%. Univariate analysis showed that the age was 60 years old and had a long history of smoking. No postoperative analgesia and 2 hours of tracheal catheter indwelling were the risk factors for postoperative pulmonary infection in EC patients (P0.05). Postoperative tracheal catheter indwelling time is an independent risk factor for lung infection in EC patients. Conclusion Gram-negative bacteria are the main pathogens of pulmonary infection after tracheal intubation in EC patients. The incidence of pulmonary infection is closely related to age, long-term smoking history, and tracheal catheter indwelling time.
【作者单位】：浙江省肿瘤医院麻醉科;
【基金】：浙江省卫生厅基金资助项目(2013KYB049)
【分类号】：R563.1

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