摘要
目的研究高龄患者气管插管全麻术后肺部感染的病原菌特点及危险因素分析,为临床预防提供理论依据。方法选取2013年1月-2017年6月在本院全麻手术的高龄患者(年龄≥65周岁) 486例,收集患者呼吸道分泌物,采用细菌自动分析仪对所培养细菌进行分离鉴定,对全麻术后肺部感染的相关因素使用单因素和多因素Logistic回归分析,并提出相关的干预措施。结果 486例高龄患者全身麻醉术后52例发生肺部感染,感染发生率为10. 70%。52例肺部感染患者共培养出58株病原菌,其中革兰阳性菌14例,占24. 14%,革兰阴性菌42株,占72. 41%,真菌感染2例,占3. 45%。单因素和多因素Logistic回归分析显示,麻醉插管时间≥120 min、经口气管插管、有肺部疾病史、术后使用呼吸机是气管插管全麻术后高龄患者发生呼吸道感染的独立危险因素。结论高龄患者气管插管全麻术病原菌以革兰阴性菌为主,针对相关危险因素临床应改进和完善控制方法,可以预防肺部感染发生。
Objective To study the characteristics and risk factors of pathogenic bacteria in elderly patients with pulmonary infection after tracheal intubation general anesthesia,so as to provide theoretical basis for clinical prevention. Methods A total of 486 elderly patients( ≥65 years old) undergoing general anesthesia in our hospital from January 2013 to June 2017 were enrolled in this study. The respiratory secretions of patients were collected. The bacteria were separated and identified by automatic analyzer. Relevant factors of post-anesthetic pulmonary infection were analyzed using univariate and multivariate Logistic regression,and related interventions were proposed. Results In 486 elderly patients undergoing general anesthesia,pulmonary infection occurred in 52 patients,the incidence of infection was 10. 70%. Fifty-eight strains of pathogenic bacteria were co-cultured in 52 patients with pulmonary infection,of which 14 were Gram-positive bacteria,accounting for 24. 14%,42 were Gram-negative bacteria,accounting for 72. 41%,and 2 were fungal infections,accounting for 3. 45%. Univariate and multivariate Logicstics regression analysis showed that intubation time ≥120 min,orotracheal intubation,history of pulmonary disease,breathing machine assistance were independent risk factors for respiratory infections in the elderly patients after tracheal intubation general anesthesia. Conclusion Gram-negative bacteria is the main pathogenic bacteria of tracheal intubation and general anesthesia in elderly patients. To improve and perfect the control methods for the relevant risk factors can prevent pulmonary infection.
作者
陈晓丽
徐珊
CHEN Xiao -1i;XU Shan(Department of Anesthesia,the First People's Hospital of Yongkang,Yongkang,Zhefiang 321300,China)
出处
《中国卫生检验杂志》
CAS
2018年第23期2921-2923,共3页
Chinese Journal of Health Laboratory Technology
关键词
气管插管
高龄患者
全身麻醉
肺部感染
Endotracheal intubation
Elderly patients
General anesthesia
Pulmonary infection
