手术麻醉相关下呼吸道感染的危险因素及预防措施

发布时间：2018-05-16 13:49

本文选题：应对措施 + 手术麻醉　；参考：《中华医院感染学杂志》2017年16期

【摘要】：目的分析手术麻醉相关下呼吸道感染的危险因素,制定应对措施,为预防下呼吸道感染提供参考依据。方法选取2014年10月-2016年12月医院收治的500例手术麻醉患者为研究对象,回顾性分析其术后发生下呼吸道感染情况,采集感染患者的痰液标本进行培养鉴定,分析病原菌的分布特征,同时对手术麻醉相关下呼吸道感染的危险因素进行单因素和多因素分析。结果 500例手术麻醉患者中,发生下呼吸道感染51例,感染率为10.2%;感染患者的基础疾病分布,以神经系统疾病所占比例最高,占35.29%;51份痰液标本中共分离出69株病原菌,其中革兰阴性菌39株占56.52%,革兰阳性菌27株占39.13%,其他菌2株占4.35%;单因素分析结果显示,麻醉方式、麻醉时间、麻醉机消毒方式、抗菌药物使用、麻醉机过滤器的使用与手术麻醉相关下呼吸道感染的发生具有相关性(P0.05);多因素logistic回归分析结果显示,麻醉方式、麻醉时间、消毒方式、抗菌药物的使用及麻醉机过滤器的使用是引发下呼吸道感染的独立危险因素。结论手术麻醉相关下呼吸道感染的危险因素较多,临床上应对以上不利因素早期进行预防控制,以降低下呼吸道感染的发生,提高手术治疗效果。
[Abstract]:Objective to analyze the risk factors of lower respiratory tract infection associated with anesthesia and to provide reference for prevention of lower respiratory tract infection. Methods from October 2014 to December 2016, 500 patients with operation anesthesia were selected as study objects. The incidence of lower respiratory tract infection after operation was analyzed retrospectively, and sputum samples of infected patients were collected for culture and identification. The distribution of pathogenic bacteria was analyzed, and the risk factors of lower respiratory tract infection related to anesthesia were analyzed by univariate and multivariate analysis. Results among the 500 anesthetized patients, 51 cases had lower respiratory tract infection, and the infection rate was 10.2. The distribution of basic diseases in infected patients was the highest, with the proportion of nervous system diseases accounting for the highest, accounting for 35.29% of 51 sputum samples. 69 strains of pathogenic bacteria were isolated from the sputum samples. Among them, 39 strains of Gram-negative bacteria accounted for 56.52%, 27 strains of Gram-positive bacteria accounted for 39.13%, and 2 strains of other bacteria accounted for 4.35.The results of single factor analysis showed that anesthetic methods, anesthetic time, disinfection methods of anesthetic machines, and use of antimicrobial agents, There was a correlation between the use of anesthetic filter and the incidence of lower respiratory tract infection associated with operation (P 0.05). The results of multivariate logistic regression analysis showed that anesthesia mode, anesthesia time, disinfection mode, The use of antimicrobial agents and anesthetic filters are independent risk factors for lower respiratory tract infections. Conclusion there are many risk factors of lower respiratory tract infection associated with anesthesia, so early prevention and control of these adverse factors should be carried out in order to reduce the incidence of lower respiratory tract infection and improve the effect of surgical treatment.
【作者单位】：宁波市镇海区人民医院麻醉科;宁波市镇海区人民医院骨科;
【分类号】：R614

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