耳鼻喉科患者低温等离子术后医院感染分析

发布时间：2018-01-17 17:10

本文关键词：耳鼻喉科患者低温等离子术后医院感染分析　出处：《中华医院感染学杂志》2014年13期 　论文类型：期刊论文

【摘要】：目的观察耳鼻喉科患者低温等离子术后医院感染的原因、临床表现及影响因素,以利抗菌药物的合理应用。方法选择医院2010年3月-2013年3月耳鼻喉科行低温等离子手术患者1 050例,其中发生医院感染43例,设为感染组,未发生医院感染1 007例,设为对照组,就感染率、感染发生相关原因、主要病原菌及临床表现进行分析,并观察围术期抗菌药物使用情况;数据采用SPSS13.0统计处理。结果 1 050例行低温等离子手术患者中共发生医院感染43例,感染率为4.10%,以手术部位感染最高,占48.84%;其次是呼吸道感染16例占37.22%,消化道感染6例占13.95%;手术时间长、≥2种预防性抗菌药物联用、合并糖尿病、营养状况差、高龄等是易感因素(P0.05);共培养出病原菌47株,以革兰阳性菌为主27株占57.45%,革兰阴性菌20株占42.55%,前5位病原菌依次是金黄色葡萄球菌、凝固酶阴性葡萄球菌、大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌,分别占27.66%、23.40%、14.89%、12.77%、8.51%;所有患者均根据近期抗菌谱给予敏感抗菌药物治疗后感染得到控制,无其他相关并发症发生。结论低温等离子术虽然是耳鼻喉科安全微创的手术方式,但如未做好防护,也容易导致医院感染,因此,术前评估,高危患者采取有效干预,手术时间长的患者做好感控预防是降低感染发生率的必要措施。
[Abstract]:Objective to observe the causes, clinical manifestations and influencing factors of nosocomial infection after hypothermia plasma surgery in patients with otolaryngology. Methods from March 2010 to March 2013, 1 050 patients underwent hypothermia plasma surgery in the department of otolaryngology, including 43 cases of nosocomial infection. There were 1 007 cases of nosocomial infection in the infection group and 1 007 cases in the control group. The infection rate, the causes of infection, the main pathogenic bacteria and the clinical manifestations were analyzed, and the use of antibiotics in perioperative period was observed. Results there were 43 cases of nosocomial infection in 1 050 patients undergoing hypothermia plasma surgery, the infection rate was 4.10%, the highest infection occurred in the operation site. 48.84; The second was respiratory tract infection in 16 cases (37.22) and digestive tract infection in 6 cases (13.95%). Long operation time, combined use of more than 2 prophylactic antimicrobial agents, diabetes mellitus, poor nutritional status, and old age were the predisposing factors. A total of 47 strains of pathogenic bacteria were cultured, 27 of which were Gram-positive bacteria (57.45), 20 were Gram-negative bacteria (42.55), and the first 5 were Staphylococcus aureus (Staphylococcus aureus). Coagulase negative staphylococci, Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae accounted for 27.66% and 23.40% respectively. All patients were treated with sensitive antimicrobial drugs according to the recent antimicrobial spectrum infection was controlled without other related complications. Conclusion hypothermia plasma surgery is a safe and minimally invasive method in otolaryngology. But it is easy to cause nosocomial infection if it is not well protected. Therefore, it is necessary to reduce the incidence of infection by preoperative evaluation, effective intervention of high risk patients and good control prevention of patients with long operation time.
【作者单位】：贵州省黔东南州人民医院耳鼻咽喉科;
【基金】：贵州省卫生厅重点扶持基金资助项目(GW-2010A-1022)
【分类号】：R762
【正文快照】： 低温等离子射频消融手术(Coblation)是20世纪90年代应用于临床的先进、微创的外科技术,该技术自临床应用以来[1],在喉、鼻等消融手术中取得了较好的效果。随着Coblation技术的日益成熟[2],临床适应证不断扩大,近年来还用于鼻咽部肿瘤及其他器官疾病的治疗,以其创伤小、术后疼

【参考文献】