过氧化氢深漱口对全身麻醉气管插管患者肺部感染的预防效果研究

发布时间：2018-10-29 20:33

【摘要】：目的分析普外科择期手术全身麻醉的患者在气管插管后发生肺部感染情况,术前采用过氧化氢深漱口,以降低肺部感染发生率。方法将普外科2013年1-12月择期手术全麻的患者共294例随机分为试验组150例和对照组144例;对照组的患者在手术前其口腔不给予任何预防措施,试验组患者均给予1.5%过氧化氢深漱口,观察并记录两组患者的术后一周肺部感染发生率。结果对照组144例患者术后一周发生肺部感染22例,感染率15.3%,试验组150例患者术后一周发生肺部感染6例,感染率4.0%,试验组患者术后感染率明显低于对照组,差异有统计学意义(P0.05);过氧化氢深漱口前后的患者口腔菌落数发生明显变化,而且气管导管的前端菌落数明显下降,差异有统计学意义(P0.05),感染患者送检痰液标本培养出病原菌共42株,试验组检出9株,占21.4%,对照组检出33株占78.6%,检出病原菌主要为金黄色葡萄球菌、鲍氏不动杆菌、铜绿假单胞菌、阴沟肠杆菌、肺炎克雷伯菌、表皮葡萄球菌、大肠埃希菌、真菌等。结论过氧化氢口腔深漱口可以降低患者口腔中的病原菌含量,也可以明显降低择期手术全身麻醉患者在气管插管后的肺部感染,值得临床推广应用。
[Abstract]:Objective to analyze the incidence of pulmonary infection in patients undergoing general anesthesia after tracheal intubation, and to reduce the incidence of pulmonary infection by using hydrogen peroxide deep gargle before operation. Methods 294 patients undergoing elective general anesthesia from January to December 2013 were randomly divided into trial group (n = 150) and control group (n = 144). The patients in the control group were not given any preventive measures before operation. The patients in the experimental group were given 1.5% hydrogen peroxide deep gargle. The incidence of pulmonary infection was observed and recorded one week after operation in both groups. Results in the control group, there were 22 patients with pulmonary infection one week after operation, and the infection rate was 15.3. in the test group, there were 6 patients with pulmonary infection one week after operation, and the infection rate was 4.0. the infection rate of the patients in the test group was significantly lower than that in the control group. The difference was statistically significant (P0.05). Before and after hydrogen peroxide deep gargle, the number of oral colonies changed significantly, and the number of the anterior end of trachea catheter decreased significantly (P0.05). 42 strains of pathogenic bacteria were cultured in sputum samples of infected patients. Nine strains (21.4%) were detected in the test group and 33 strains (78.6%) in the control group. The main pathogens were Staphylococcus aureus, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter cloacae, Klebsiella pneumoniae and Staphylococcus epidermidis. Escherichia coli, fungi, etc. Conclusion hydrogen peroxide oral deep gargle can reduce the pathogenic bacteria content in the oral cavity and the pulmonary infection after tracheal intubation in patients undergoing elective general anesthesia, which is worthy of clinical application.
【作者单位】：首都医科大学附属北京世纪坛医院麻醉科;
【基金】：北京市自然科学基金资助项目(7112555)
【分类号】：R614

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