老年患者全麻手术后下呼吸道感染的危险因素与病原学分析

发布时间：2018-02-08 16:12

本文关键词： 上腹部全麻术下呼吸道感染危险因素病原学特点　出处：《中华医院感染学杂志》2015年12期 　论文类型：期刊论文

【摘要】：目的探讨老年患者上腹部全麻术后发生下呼吸道感染的危险因素及其病原学特点,为采取相关预防措施以及选用敏感抗菌药物治疗下呼吸道感染提供依据。方法回顾性分析2011年8月-2014年9月350例行上腹部全麻术的患者临床资料,对发生下呼吸道感染患者进行干预治疗,分析发生下呼吸道感染的相关因素及病原学特点,并进行多因素logistic回归分析。结果 350例老年患者发生下呼吸道感染50例,感染率为14.28%;共分离出病原菌59株,以革兰阴性菌为主占77.97%,并有17株为多药耐药菌;吸烟史、合并基础疾病、肿瘤、入住ICU、手术部位、手术时间、麻醉持续时间、插管途径以及术后拔管时间与患者下呼吸道感染的发生明显相关,差异有统计学意义(P0.05);合并基础疾病、入住ICU、麻醉持续时间长、插管途径以及术后拔管时间是患者发生下呼吸道感染的独立危险因素(P0.05)。结论老年患者经上腹部全麻术后,多种危险因素均加大下呼吸道感染风险,临床上应加强对该危险因素的控制,以降低患者发生下呼吸道感染的风险。
[Abstract]:Objective to investigate the risk factors and etiological characteristics of lower respiratory tract infection after epigastric general anesthesia in elderly patients. Methods the clinical data of 350 patients undergoing epigastric general anesthesia from August 2011 to September 2014 were retrospectively analyzed. Patients with lower respiratory tract infection were treated with intervention, and the related factors and etiological characteristics of lower respiratory tract infection were analyzed, and multivariate logistic regression analysis was carried out. Results 50 cases of lower respiratory tract infection occurred in 350 elderly patients. The infection rate was 14.28%, 59 strains of pathogenic bacteria were isolated, 77.97 strains were Gram-negative bacteria, and 17 strains were multidrug resistant bacteria, smoking history, combined with basic diseases, tumor, admission to ICU, site of operation, operation time, duration of anesthesia, Intubation pathway and extubation time were significantly related to the incidence of lower respiratory tract infection, the difference was statistically significant (P0.05N), combined with basic diseases, admitted to ICU, long duration of anesthesia, Intubation pathway and extubation time were the independent risk factors of lower respiratory tract infection in patients. Conclusion after epigastric general anesthesia, many risk factors increase the risk of lower respiratory tract infection in elderly patients. In order to reduce the risk of lower respiratory tract infection, we should strengthen the control of this risk factor in clinic.
【作者单位】：临安市人民医院麻醉科;台州市第一人民医院麻醉科;
【基金】：浙江省卫生厅基金资助项目(2013KYB228)
【分类号】：R614.2

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