【摘要】：目的探究誘發(fā)心臟瓣膜置換術(shù)患者肺部感染相關(guān)因素,并提出相應(yīng)預(yù)防措施。方法隨機(jī)選取2014年8月-2016年8月醫(yī)院收治的接受心臟瓣膜置換術(shù)治療的60例心臟瓣膜疾病患者,觀察患者手術(shù)治療后肺部感染情況,分析感染的誘發(fā)因素,并制定有效的預(yù)防措施。結(jié)果經(jīng)心臟瓣膜置換術(shù)治療后患者的中心靜脈壓(CVP)、心臟指數(shù)(CI)、全心舒張末期容積指數(shù)(GEDI)[(9.68±0.98)mmHg、5.98±0.43、887.89±31.87]等血流動(dòng)力學(xué)指標(biāo)明顯優(yōu)于治療前[(13.78±1.57)mmHg、4.19±0.34、768.86±28.86],差異有統(tǒng)計(jì)學(xué)意義(P0.05);60例患者中,術(shù)后20例患者發(fā)生肺部感染,感染率為33.33%,感染患者共分離出病原菌20株,其中,革蘭陰性菌14株占70.00%,革蘭陽性菌5株占25.00%,真菌1株占5.00%;感染組患者左心室射血分?jǐn)?shù)(LVEF)、氣管插管拔管時(shí)間及呼吸機(jī)使用時(shí)間[(44.23±12.12)%、(29.39±7.01)h、(16.97±5.46)h]與非感染組患者[(56.10±13.23)%、(24.13±6.44)h、(11.29±4.53)h]相比差異有統(tǒng)計(jì)學(xué)意義(P0.05);感染組患者胸骨哆開、再次開胸止血、低心排綜合征發(fā)生率與非感染組患者相比明顯增高,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論誘發(fā)心臟瓣膜置換術(shù)后肺部感染因素主要有LVEF、呼吸機(jī)使用時(shí)間、氣管拔管時(shí)間、再次開胸止血、胸骨哆開、低心排綜合征等;采取針對性措施,可降低肺部感染發(fā)生率,提高患者治療預(yù)后。
[Abstract]:Objective to investigate the related factors of pulmonary infection in patients undergoing cardiac valve replacement and to put forward corresponding preventive measures. Methods from August 2014 to August 2016, 60 patients with heart valve disease treated by cardiac valve replacement were randomly selected to observe the pulmonary infection after surgical treatment, and analyze the inducing factors of infection. And make effective preventive measures. Results the hemodynamic indexes such as central venous pressure (CVP), cardiac index (CI), total cardiac end-diastolic volume index (GEDI) [(9.68 鹵0.98) mm HgN 5.98 鹵0.43887.89 鹵31.87] were significantly better than those before the treatment [(13.78 鹵1.57) mm Hg 4.19 鹵0.34768.86 鹵28.86] (P 0.05). Twenty patients developed pulmonary infection after operation, the infection rate was 33.33%. 20 strains of pathogenic bacteria were isolated from the infected patients. There were significant differences in left ventricular ejection fraction (LVEF), tracheal intubation extubation time and ventilator use time (44.23 鹵12.12), (29.39 鹵7.01) h, (16.97 鹵5.46) h between infected group and non-infected group [(56.10 鹵13.23) h, (24.13 鹵6.44) h, (11.29 鹵4.53) h] The sternum in the infected group was doxotomized. The incidence of low cardiac output syndrome was significantly higher than that of non-infection group (P0.05). Conclusion the main causes of pulmonary infection after cardiac valve replacement are LVEF, time of ventilator use, time of tracheal extubation, reopening of chest to stop bleeding, sternum reopening, low cardiac output syndrome and so on. To improve the prognosis of patients.
【作者單位】： 海南醫(yī)學(xué)院附屬醫(yī)院心臟外科;
【分類號】：R563.1;R654.2

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