摘要
目的探讨上消化道穿孔患者术后肺部感染的临床分析及干预对策,以期提高临床治疗水平。方法回顾性分析2010年1月-2013年1月65例上消化道穿孔手术患者,对其中的12例肺部感染患者临床表现、病原菌和危险因素等采用SPSS16.0进行分析。结果上消化道穿孔患者术后肺部感染临床表现以发热、咳嗽、咳痰、胸闷、气短等肺部感染为主,实验室以白细胞和C-反应蛋白升高为主;病原菌以革兰阴性菌中以铜绿假单胞菌和肺炎克雷伯菌为主,占52.6%;其中年龄>65岁、术后未镇痛、全麻、有肺部慢性基础疾病、胃肠减压时间>48h、术前存在休克是上消化道穿孔术后肺部感染危险因素(P<0.05);经过综合治疗后治愈率为90.77%。结论上消化道穿孔术后肺部感染临床表现明显,早期干预可提高预后。
OBJECTIVE To explore the risk factors for postoperative pulmonary infections in the patients undergoing upper gastrointestinal perforation and put forward intervention measures so as to raise the level of clinical treatment.METHODS A total of 65 patients who underwent the upper gastrointestinal perforation from Jan 2010 to Jan2013were retrospectively reviewed,then the clinical manifestations of 12 patients with pulmonary infections,distribution of pathogens,and risk factors were analyzed with the use of SPSS16.0 software.RESULTS The major clinical manifestations of the upper gastrointestinal perforation patients with postoperative pulmonary infections included the fever,cough,expectum;the elevated levels of leukocytes and C-reactive protein were found in the clinical laboratory.Pseudomonas aeruginosa and Klebsiella pneumoniae were the predominant species of pathogens,which were the gram-negative bacteria,accounting for 52.6%.More than 65 years of age,without postoperative analgesia,general anesthesia,chronic pulmonary underlying disease,time of gastrointestinal decompression more than 48 hours,and preoperative shock were the risk factors for the postoperative pulmonary infections in the patients undergoing the upper gastrointestinal perforation（P0.05）.The cure rate was 90.77% after the comprehensive treatment.CONCLUSION The patients with pulmonary infections after the upper gastrointestinal perforation have significant clinical manifestations,and the early intervention can improve the prognosis.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第16期4056-4058,共3页
Chinese Journal of Nosocomiology
基金
义乌市卫生局重点基金资助项目(ZY-2010A-015)
关键词
上消化道穿孔
肺部感染
临床分析
干预对策
Upper gastrointestinal perforation
Pulmonary infection
Clinical analysis
Intervention measure
