本文選題：應(yīng)對措施 + 手術(shù)麻醉��； 參考：《中華醫(yī)院感染學(xué)雜志》2017年16期

【摘要】：目的分析手術(shù)麻醉相關(guān)下呼吸道感染的危險因素,制定應(yīng)對措施,為預(yù)防下呼吸道感染提供參考依據(jù)。方法選取2014年10月-2016年12月醫(yī)院收治的500例手術(shù)麻醉患者為研究對象,回顧性分析其術(shù)后發(fā)生下呼吸道感染情況,采集感染患者的痰液標(biāo)本進行培養(yǎng)鑒定,分析病原菌的分布特征,同時對手術(shù)麻醉相關(guān)下呼吸道感染的危險因素進行單因素和多因素分析。結(jié)果 500例手術(shù)麻醉患者中,發(fā)生下呼吸道感染51例,感染率為10.2%;感染患者的基礎(chǔ)疾病分布,以神經(jīng)系統(tǒng)疾病所占比例最高,占35.29%;51份痰液標(biāo)本中共分離出69株病原菌,其中革蘭陰性菌39株占56.52%,革蘭陽性菌27株占39.13%,其他菌2株占4.35%;單因素分析結(jié)果顯示,麻醉方式、麻醉時間、麻醉機消毒方式、抗菌藥物使用、麻醉機過濾器的使用與手術(shù)麻醉相關(guān)下呼吸道感染的發(fā)生具有相關(guān)性(P0.05);多因素logistic回歸分析結(jié)果顯示,麻醉方式、麻醉時間、消毒方式、抗菌藥物的使用及麻醉機過濾器的使用是引發(fā)下呼吸道感染的獨立危險因素。結(jié)論手術(shù)麻醉相關(guān)下呼吸道感染的危險因素較多,臨床上應(yīng)對以上不利因素早期進行預(yù)防控制,以降低下呼吸道感染的發(fā)生,提高手術(shù)治療效果。
[Abstract]:Objective to analyze the risk factors of lower respiratory tract infection associated with anesthesia and to provide reference for prevention of lower respiratory tract infection. Methods from October 2014 to December 2016, 500 patients with operation anesthesia were selected as study objects. The incidence of lower respiratory tract infection after operation was analyzed retrospectively, and sputum samples of infected patients were collected for culture and identification. The distribution of pathogenic bacteria was analyzed, and the risk factors of lower respiratory tract infection related to anesthesia were analyzed by univariate and multivariate analysis. Results among the 500 anesthetized patients, 51 cases had lower respiratory tract infection, and the infection rate was 10.2. The distribution of basic diseases in infected patients was the highest, with the proportion of nervous system diseases accounting for the highest, accounting for 35.29% of 51 sputum samples. 69 strains of pathogenic bacteria were isolated from the sputum samples. Among them, 39 strains of Gram-negative bacteria accounted for 56.52%, 27 strains of Gram-positive bacteria accounted for 39.13%, and 2 strains of other bacteria accounted for 4.35.The results of single factor analysis showed that anesthetic methods, anesthetic time, disinfection methods of anesthetic machines, and use of antimicrobial agents, There was a correlation between the use of anesthetic filter and the incidence of lower respiratory tract infection associated with operation (P 0.05). The results of multivariate logistic regression analysis showed that anesthesia mode, anesthesia time, disinfection mode, The use of antimicrobial agents and anesthetic filters are independent risk factors for lower respiratory tract infections. Conclusion there are many risk factors of lower respiratory tract infection associated with anesthesia, so early prevention and control of these adverse factors should be carried out in order to reduce the incidence of lower respiratory tract infection and improve the effect of surgical treatment.
【作者單位】： 寧波市鎮(zhèn)海區(qū)人民醫(yī)院麻醉科;寧波市鎮(zhèn)海區(qū)人民醫(yī)院骨科;
【分類號】：R614

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