全麻腹部手术患者术后肺部感染的病原菌分布及相关因素分析

发布时间：2018-06-15 18:22

本文选题：全身麻醉 + 腹部手术　；参考：《中华医院感染学杂志》2017年09期

【摘要】：目的分析全麻腹部手术患者术后肺部感染的病原菌分布及相关危险因素,为医院感染的预防控制工作提供客观依据。方法选取2014年6月-2016年10月全身麻醉下行腹部手术的患者327例,对患者痰标本中的病原菌分布特征进行分析,探讨全麻腹部手术患者术后肺部感染的相关危险因素。结果患者发生术后肺部感染26例,感染率为7.9%,共分离出病原菌53株,其中革兰阴性菌、革兰阳性菌、真菌分别占56.7%、35.8%和7.5%,铜绿假单胞菌、金黄色葡萄球菌、大肠埃希菌是主要病原菌,分别占28.3%、24.5%、22.7%;年龄、手术部位、合并慢性呼吸系统疾病、合并糖尿病、吸烟情况、手术时间、侵入性操作等为术后肺部感染的相关因素(P0.05);Logistic多元回归分析结果显示,合并慢性呼吸系统疾病、合并糖尿病、手术时间≥2h、侵入性操作等因素是全麻腹部手术患者术后肺部感染的危险因素。结论全麻腹部手术患者术后肺部感染的病原菌分布和相关因素均具有一定的特征性,临床医师应采用合理的干预措施,预防和控制术后感染、改善患者的预后。
[Abstract]:Objective to analyze the distribution of pathogenic bacteria and related risk factors of pulmonary infection after general anesthesia in patients with abdominal surgery, and to provide an objective basis for the prevention and control of hospital infection. Methods 327 patients with abdominal surgery under general anesthesia in June 2014, October -2016, were selected to analyze the distribution characteristics of pathogenic bacteria in the sputum specimens of the patients. Results there were 26 cases of pulmonary infection after operation in patients with abdominal surgery. Results the postoperative pulmonary infection occurred in 26 cases, the infection rate was 7.9%, and 53 strains of pathogenic bacteria were isolated. Among them, Gram-negative bacteria, Gram-positive bacteria and fungi accounted for 56.7%, 35.8% and 7.5% respectively, Pseudomonas aeruginosa, Staphylococcus aureus and Escherichia coli were the main pathogens. Do not take 28.3%, 24.5%, 22.7%; age, surgical site, chronic respiratory disease, diabetes, smoking, operation time, invasive operation, and other related factors of postoperative pulmonary infection (P0.05); Logistic multivariate regression analysis showed that the complication of slow respiratory system, diabetes, operation time more than 2h, invasive operation These factors are the risk factors of postoperative pulmonary infection in patients undergoing general anesthesia for abdominal surgery. Conclusion the distribution of pathogenic bacteria and related factors of pulmonary infection after operation in general anesthesia patients have certain characteristics. The clinicians should adopt reasonable intervention measures to prevent and control postoperative infection and improve the prognosis of the patients.
【作者单位】：无锡市第九人民医院麻醉科;无锡市第九人民医院骨科;无锡市第九人民医院院感科;无锡市第四人民医院麻醉科;
【基金】：江苏省卫生厅基金资助项目(H201447)
【分类号】：R614.2

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