摘要
目的探讨髋关节置换手术后患者下呼吸道感染的危险因素,为髋关节置换手术后下呼吸道感染的预防和治疗提供参考。方法选取2010年1月-2012年12月医院收治的80例髋关节置换术患者为研究对象,选取性别、年龄、合并基础疾病,机械通气时间、抑酸药物使用、手术时间、白蛋白水平、APACHEⅡ评分等影响下呼吸道感染相关因素进行单因素χ2和logistic多因素回归分析。结果收治的80例髋关节置换手术患者手术后发生下呼吸道感染22例,发生率27.5%;单因素分析结果显示患者年龄、合并基础疾病,机械通气时间、胃管留置、抗菌药物使用、手术时间、白蛋白水平、APACHEⅡ评分与术后下呼吸道感染有关(P<0.05),而与性别无相关性(P>0.05);经logistic多因素回归分析机械通气时间(χ2=4.638,P=0.032)、手术时间(χ2=6.137,P=0.014)、年龄(χ2=6.798,P=0.008)、抑酸药物使用(χ2=3.876,P=0.048)是髋关节置换手术后患者并发下呼吸道感染的主要危险因素。结论引发髋关节置换手术后患者并发下呼吸道感染的因素有很多,重视术前评估,加强术前准备,缩短手术时间,合理应用抗菌药物,加强患者的基础护理,做到早诊断、早治疗等措施有助于下呼吸道感染的预防与控制。
OBJECTIVE To explore the risk factors of concurrent lower respiratory tract infections after hip replacement surgery so as to provide bases for the prevention and treatment of the postoperative lower respiratory tract infections. METHODS Totally 80 cases of patients who underwent hip replacement surgery in the hospital from Jan 2010 to Dec 2012 were chosen as the study objects and divided into two groups according to whether or not the postoperative lower respiratory tract infections occurred, then the univariate analysis and multivariate logistic regression analysis were performed for the risk factors of postoperative lower respiratory tract infections including the gender, age, complication of underlying disease, use of antacids, operation duration, level of albumin, and APACHE II score. RESULTS Of totally 80 patients who underwent the hip replacement surgery, the postoperative lower respiratory tract infections occurred in 22 cases with the incidence rate of 27. 5%. The result of univariate analysis indicated that the age, complication of underlying diseases, mechanical ventilation duration, gastric catheter indwelling, use of antibiotics, operation duration, level of albumin, and APACHE Ⅱ score were associated with the postoperative lower respiratory infections（P〈0.05）, without the relation with the gender （P〉0.05）; the multivariate logistic regression analysis showed that the mechanical ventilation duration （X2 = 4. 638, P = 0. 032）, operation duration（x2 = 6. 137, P = 0. 014）, age（X2 = 6. 798, P = 0. 008）, use of antacids （X2=3. 876 ,P=0. 048） were the main risk factors for the postoperative lower respiratory infections in the patients undergoing hip replacement surgery. CONCLUSION There are many factors associated with the concurrent lower respiratory tract infections in the patients after hip replacement surgery. To attach great importance to the preoperative evaluation, strengthen the preoperative preparation, shorten the operation duration, reasonably use antibiotics, and e
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第22期5436-5437,5440,共3页
Chinese Journal of Nosocomiology
基金
河北省科技厅科技基金项目(12276104D-62)
关键词
下呼吸道感染
高危因素
髋关节置换术
Lower respiratory tract infection
High risk factor
Hip replacement surgery
