高龄患者全身麻醉气管插管术后下呼吸道感染病原学特点及危险因素分析

发布时间：2018-01-19 05:25

本文关键词： 高龄患者全身麻醉下呼吸道感染病原学特点危险因素　出处：《中华医院感染学杂志》2017年21期 　论文类型：期刊论文

【摘要】：目的研究高龄患者全身麻醉气管插管术后发生下呼吸道感染的病原学特点及危险因素,制定相关预防控制措施,为临床治疗提供参考依据。方法选取2016年01月-2017年01月医院收治的400例全麻气管插管术高龄患者为研究对象,分析其病原学特点及危险因素。结果 400例高龄患者中48例发生下呼吸道感染,感染率为12.0%;感染患者下呼吸道分泌物中分离出41株病原菌,其中革兰阳性菌11株,占26.83%,革兰阴性菌28株,占68.29%,真菌2株,占4.99%;其中患者吸烟、气管插管途径、气管插管深度、手术时间、术后拔管时间、合并基础疾病均与下呼吸道感染发生率密切相关,差异具有统计学意义(P0.05);经多因素logistic回归分析显示,气管插管途径、气管插管深度、手术时间、拔管时间、合并基础疾病为全身麻醉术后下呼吸道感染的独立危险因素(P0.05)。结论高龄患者行全身麻醉气管插管术后发生下呼吸道感染的概率高、危险因素多,针对相关危险因素临床应进行干预,以预防下呼吸道感染发生。
[Abstract]:Objective to study the etiological characteristics and risk factors of lower respiratory tract infection after tracheal intubation under general anesthesia in elderly patients and to establish relevant preventive and control measures. Methods from January 2016 to January 2017, 400 elderly patients undergoing general anesthesia tracheal intubation were selected as the research objects. Results among 400 elderly patients, 48 cases had lower respiratory tract infection, the infection rate was 12.0%. 41 strains of pathogenic bacteria were isolated from the lower respiratory tract secretions of the infected patients, of which 11 were Gram-positive bacteria (26.83%), 28 Gram-negative bacteria (68.29%) and 2 fungi (4.99%). The incidence of lower respiratory tract infection was closely related to smoking, tracheal intubation pathway, depth of endotracheal intubation, operation time, postoperative extubation time, combined with basic diseases. The difference was statistically significant (P 0.05). Multivariate logistic regression analysis showed that tracheal intubation pathway, intubation depth, operation time, extubation time. Basic diseases were the independent risk factors of lower respiratory tract infection after general anesthesia. Conclusion the incidence of lower respiratory tract infection after general anesthesia tracheal intubation in elderly patients is high and there are many risk factors. In order to prevent lower respiratory tract infection, clinical intervention should be carried out for related risk factors.
【作者单位】：河南省新乡市第二人民医院麻醉科;
【分类号】：R614.2
【正文快照】： 全身麻醉是经气道吸入、肌注或静脉注射麻醉药后对中枢系统产生暂时抑制,表现为全身痛觉消失、神志消失、骨骼肌松弛、反射抑制等;能减轻患者痛苦和保驾手术顺利进行。气管插管为全麻后气道管理的常用方法之一。气管插管破坏了上呼吸道天然屏障,使患者鼻腔及咽喉失去保护,进而

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