摘要
目的研究胃癌患者术后肺部感染病原菌分布及围术期干预措施分析。方法选取2015年12月-2016年12月医院行胃癌手术治疗的患者300例,将300例患者分为试验组和对照组,每组患者150例。对照组患者采取常规的外科临床干预措施,试验组患者在常规临床干预的基础上强化围手术期的临床干预,观察两组患者行胃癌治疗手术后肺部感染的情况。对术后肺部感染患者进行调查分析,取其标本做细菌培养和药敏试验。结果试验组患者发生肺部感染3例,对照组患者发生肺部感染18例,差异有统计学意义(P<0.05);观察组患者在术后排气时间、应用抗菌药物时间、住院时间、术后氧分压、二氧化碳分压等指标均优于对照组,此外,试验组患者术后第一时间的肺活量高于对照组,差异有统计学意义(P<0.05);21例送检标本分离出病原菌18株,其中革兰阴性菌12株,占66.67%;革兰阳性菌4株,占22.22%;真菌2株,占11.11%。结论肺部感染患者感染病原菌以革兰阴性菌为主,加强围手术期的临床干预措施可提高胃癌患者术后肺活量,降低肺部感染风险。
OBJECTIVE To explore the distribution of pathogens causing postoperative pulmonary infection in patients with gastric cancer and put forward the preoperative intervention measures.METHODS A total of 300 patients with gastric cancer who received surgical procedures in the hospital from Dec 2015 to Dec 2016 were enrolled in the study and divided into the experimental group and the control group,with 150 cases in each group.The control group was treated with conventional surgical interventions,while the experimental group was given intensified clinical inventions during the perioperative period on basis of the conventional clinical interventions.The incidence of postoperative pulmonary infection was observed and compared between the two groups of patients.The patients with the postoperative pulmonary infection were investigated and analyzed,the specimens were obtained for bacterial culture,and the drug susceptibility testing was performed.RESULTS Totally 3 patients had pulmonary infection in the experimental group,18 patients in the control group,and there was significant difference（P〈0.05）.The postoperative exhaust time,time of use of antibiotics,length of hospital stay,postoperative partial pressure of oxygen and partial pressure of carbon dioxide were significantly better in the observation group than in the control group,in addition,the postoperative first-time vital capacity of the experimental group was significantly higher than that of the control group（P〈0.05）.Totally 21 strains of pathogens were isolated from the submitted specimens of 21 patients,12（66.67%）of which were gram-negative bacteria,4（22.22%）were gram-positive bacteria,and 2（11.11%）were fungi.CONCLUSIONThe gram-negative bacteria are dominant among the pathogens causing the postoperative pulmonary infection,and it is necessary to strengthen the clinical interventions during the perioperative period so as to improve the vital capacity of the patients with gastric cancer and reduce the risk of pulmonary infection.
作者
许文婷
谢佳明
程孝惠
丁红
XU Wen-ting;XIE Jia-ming;CHENG Xiao-hui;DING Hong(The Second Hospital Affiliated to Suzhou University,Suzhou,Jiangsu 215004,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第13期1987-1989,共3页
Chinese Journal of Nosocomiology
基金
江苏省卫生计生委医学科研基金资助项目(H201534)
关键词
围手术期
胃癌
肺部感染
病原菌分布
Perioperative period
Gastric cancer
Pulmonary infection
Distribution of pathogen
