摘要
目的探讨气管插管全麻术患者术后发生下呼吸道感染的危险因素及相关预防治疗措施。方法回顾性分析2010年9月-2014年11月在医院行气管插管全麻术的675例患者临床资料,其中50例患者术后发生下呼吸道感染,分析患者发生下呼吸道感染的相关因素;并进一步通过多因素logistic回归分析患者发生下呼吸道感染的危险因素。结果 675例行气管插管全麻术患者,术后发生下呼吸道感染50例,感染率7.4%;下呼吸道感染患者的痰液培养出31株病原菌,其中革兰阴性菌25株占80.6%,革兰阳性菌5株占16.2%,真菌1株占3.2%;单因素分析显示,年龄≥50岁、有吸烟史、麻醉时间>3h、合并基础疾病、插管部位、插管途径、拔管时间延迟以及插管深度与下呼吸道感染的发生明显相关,且差异有统计学意义(P<0.05);进一步多因素分析显示,年龄≥50岁、麻醉时间>3h、插管途径、插管部位、插管深度以及拔管时间延迟是患者发生下呼吸道感染的独立危险因素(P<0.05)。结论临床上应该加强对该危险因素的控制,以降低患者发生下呼吸道感染的风险。
OBJECTIVE To explore the risk factors for postoperative lower respiratory tract infections in the patients undergoing endotracheal intubation under general anesthesia and put forward the related prevention measures .METHODS The clinical data of 675 patients who underwent the endotracheal intubation under general anesthesia from Sep 2010 to Nov 2014 were retrospectively analyzed ,totally 50 patients had the postoperative lower respiratory tract infections ,the related factors for the lower respiratory tract infections were analyzed ,and the multivariate logistic regression analysis was performed for the risk factors for the lower respiratory tract infections .RESULTS The postoperative lower respiratory tract infections occurred in 50 of 675 patients undergoing endotracheal intubation under general anesthesia , with the infection rate of 7 .4% . A total of 31 strains of pathogens have been isolated from the sputum specimens obtained from the patients with the lower respiratory tract infections ,including 25 （80 .6% ） strains of gram‐negative bacteria ,5 （16 .2% ） strains of gram‐positive bacteria ,and 1 （3 .2% ） strain of fungus . The univariate analysis indicated that the incidence of the lower respiratory tract infections was significantly associated with the no less than 50 years of age ,smoking history , anesthesia time more than 3 hours ,complication of underlying disease ,catheterization site ,intubation approach , delay of extubation , and intubation depth , and the difference was statistically significant （ P〈 0 .05 ） . The multivariate analysis further revealed that the no less than 50 years of age ,anesthesia time more than 3 hours , intubation approach ,catheterization site ,intubation depth ,and delay of extubation were the independent risk factors for the lower respiratory tract infections （P〈 0 .05）.CONCLUSION It is necessary for the hospital to strengthen the control of the risk factors so as to reduce the risk of the lower respiratory tract infections .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第12期2793-2795,共3页
Chinese Journal of Nosocomiology
基金
浙江省卫生厅基金资助项目(2013KYB294)
关键词
全麻气管插管术
下呼吸道感染
危险因素
Endotracheal intubation under general anesthesia
Lower respiratory tract infection
Risk factor
