摘要
目的对食管癌(EC)患者气管插管全麻术后肺部感染的病原菌分布及危险因素进行分析,为肺部感染预防控制提供依据。方法选择2012年8月-2015年2月在医院接受气管插管全麻手术治疗的770例EC患者进行研究,对发生肺部感染的80例EC患者临床资料进行回顾性分析,分析术后发生肺部感染患者的病原菌分布特点以及其危险因素。结果 770例患者发生肺部感染80例,感染率10.4%;共分离出病原菌83株,其中革兰阴性菌56株占67.8%,革兰阳性菌22株占26.2%,真菌5株占6.0%;单因素分析显示,年龄>60岁、有长期吸烟史、无术后镇痛和术后气管导管留置时间>2h是EC患者术后发生肺部感染的危险因素,差异有统计学意义(P<0.05);多因素回归分析显示,年龄、长期吸烟史、术后气管导管留置时间是EC患者发生肺部感染的独立危险因素。结论 EC患者气管插管全麻术后肺部感染病原菌以革兰阴性菌为主,肺部感染的发生与年龄、长期吸烟史、术后气管导管留置时间密切相关。
OBJECTIVE To analyze the pathogenic distribution and risk factors of pulmonary infections in esophage‐al cancer patients after general anesthesia with tracheal intubation ,so as to provide evidence for the prevention and control of lung infections .METHODS Totally 770 EC patients received general anesthesia with tracheal intubation from Aug .2012 to Feb .2015 were chosen as study objects .Among them ,80 cases appeared lung infections and their clinical data were analyzed retrospectively to find out the distribution features of the pathogens and risk fac‐tors of lung infections .RESULTS A total of 80 cases got lung infections in the 770 cases and the infection rate was 10 .4% .There were 83 strains of pathogens isolated from the infected patients ,including 56 strains of gram‐nega‐tive bacteria （67 .8% ） and 22 strains of gram‐positive bacteria （26 .2% ） and 5 strains of fungi （6 .0% ） .Single factor analysis showed that over 60 years of age ,long history of smoking ,lack of postoperative analgesia and over 2 hours of tracheal catheter indwelling time were risk factors for lung infections and the differences were significant （P〈0 .05） .Multiple logistic regression analysis showed that age ,long history of smoking ,indwelling time after the surgery were independent risk factors for lung infections .CONCLUSION Gram‐negative bacteria were the main pathogens causing pulmonary infections in patients with EC after general anesthesia with tracheal intubation .Pul‐monary infection is closely related to age ,long time smoking ,and postoperative tracheal catheter indwelling time .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第19期4507-4509,共3页
Chinese Journal of Nosocomiology
基金
浙江省卫生厅基金资助项目(2013KYB049)
关键词
食管癌
肺部感染
危险因素
病原菌
气管插管
Esophageal cancer
Pulmonary infection
Risk factors
Pathogen
Tracheal intubation
