老年患者全麻插管后下呼吸道感染的病原菌及相关因素与抗感染分析

发布时间：2018-06-07 18:38

本文选题：老年患者全麻插管 + 下呼吸道感染　；参考：《中华医院感染学杂志》2017年23期

【摘要】：目的探究老年患者全麻插管后下呼吸道感染的病原菌及危险因素与抗感染分析。方法选择2013年2月-2016年9月于医院行全麻气管插管手术的老年患者428例为研究对象,对患者发生下呼吸道感染的相关因素进行观察和分析;根据下呼吸道感染发生时间将感染患者分为序贯组35例和对照组32例,对照组给予头孢曲松进行抗感染治疗,序贯组给予头孢曲松和头孢克肟进行序贯抗感染治疗,对两组患者的抗感染疗效进行分析;对其痰液进行细菌培养,分析其病原菌构成。结果 428例行全麻插管的老年患者中有67例出现下呼吸道感染,感染发生率为15.65%;感染患者的痰液样本中共分离出81株病原菌,以革兰阴性菌为主,共65株占80.25%;序贯组抗感染的总有效率和细菌清除率分别为91.43%、91.43%,均高于对照组的78.13%、71.88%(P0.05);且序贯组患者的退热时间、咳嗽缓解时间、咳痰缓解时间及肺Up音消失时间均低于对照组(P0.05);序贯组的不良反应发生率为5.71%,低于对照组的25.00%(P0.05)。结论针对相关因素进行目标性、预见性干预和治疗,能有效降低相关感染情况的发生,应用抗菌药物进行序贯治疗能够获得较好的临床疗效,且临床用药安全可靠。
[Abstract]:Objective to investigate the pathogenic bacteria, risk factors and anti-infection analysis of lower respiratory tract infection in elderly patients after intubation under general anesthesia. Methods A total of 428 elderly patients undergoing general anesthesia and tracheal intubation from February 2013 to September 2016 were selected as study subjects. The related factors of lower respiratory tract infection were observed and analyzed. According to the time of occurrence of lower respiratory tract infection, the patients were divided into sequential group (n = 35) and control group (n = 32). The control group was treated with ceftriaxone and ceftriaxone, and the sequential group with ceftriaxone and cefixime was given sequential anti-infection therapy. The antiinfective efficacy of the two groups was analyzed, and the bacterial culture of sputum was carried out to analyze the pathogenic bacteria composition of the sputum. Results among 428 elderly patients undergoing general anesthesia intubation, 67 cases had lower respiratory tract infection, the incidence of infection was 15.65%, 81 strains of pathogenic bacteria were isolated from sputum of infected patients, mainly Gram-negative bacteria. The total effective rate and bacterial clearance rate of the sequential group were 91.43 and 91.43, respectively, which were higher than that of the control group (78.1388 and 71.88), and the antipyretic time and cough relief time of the sequential group were higher than that of the control group, and the total effective rate and bacterial clearance rate of the sequential group were 91.43 and 91.43, respectively. The remission time of expectoration and the time of disappearance of pulmonary up sound were lower than those of control group (P 0.05), and the incidence of adverse reactions in sequential group was 5.71, which was lower than that in control group (25.00%). Conclusion targeted, predictive intervention and treatment for related factors can effectively reduce the incidence of related infections. Sequential treatment with antimicrobial agents can obtain better clinical efficacy, and the clinical use of drugs is safe and reliable.
【作者单位】：聊城市第二人民医院麻醉科;聊城市第二人民医院介入诊疗室;
【基金】：山东省自然基金资助项目(2013ZRB14309)
【分类号】：R614

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