本文選題：開胸手術(shù)　切入點(diǎn)：胸腔感染　出處：《中華醫(yī)院感染學(xué)雜志》2017年23期 　論文類型：期刊論文

【摘要】：目的分析開胸術(shù)后合并胸腔感染患者的病原菌分布、耐藥性及相關(guān)因素,為醫(yī)院感染的預(yù)防和控制工作提供客觀依據(jù)。方法選取2009年1月-2016年12月于醫(yī)院接受開胸手術(shù)的616例患者作為研究對象;觀察分析患者術(shù)后胸腔感染的發(fā)生率,對發(fā)生胸腔感染患者的引流液體或胸水標(biāo)本中的病原菌分布及耐藥性進(jìn)行檢測和分析,對與開胸手術(shù)合并胸腔感染發(fā)生相關(guān)的危險因素進(jìn)行分析。結(jié)果 616例患者中有80例患者發(fā)生術(shù)后胸腔感染,感染率為13.0%,在感染患者的標(biāo)本共檢出病原菌80株,以革蘭陰性菌為主,共52株占65.0%;革蘭陰性菌對頭孢他啶、頭孢噻肟、頭孢吡肟、左氧氟沙星的耐藥率較高;Logistic多元回歸分析結(jié)果顯示,開胸手術(shù)合并胸腔感染的發(fā)生與手術(shù)時間、留置引流管時間、術(shù)前肺功能、術(shù)后創(chuàng)口污染具有相關(guān)性(P0.05)。結(jié)論開胸手術(shù)合并胸腔感染的病原菌分布、耐藥性及相關(guān)因素均具有一定的特征,臨床醫(yī)生應(yīng)對其給予高度重視和密切監(jiān)測,及時采取干預(yù)措施并選取敏感性抗菌藥物進(jìn)行治療,以達(dá)到提高醫(yī)院感染預(yù)防和控制效果、減少病原菌耐藥的目的。
[Abstract]:Objective to analyze the distribution of pathogens, drug resistance and related factors in patients with thoracic infection after thoracotomy. Methods from January 2009 to December 2016, 616 patients undergoing thoracotomy in hospital were selected as study subjects, and the incidence of thoracic infection after operation was observed and analyzed. The distribution and drug resistance of pathogenic bacteria in drainage fluid or pleural effusion of patients with pleural infection were detected and analyzed. Results 80 out of 616 patients had postoperative thoracic infection, and the infection rate was 13.0. A total of 80 strains of pathogenic bacteria were detected in the specimens of infected patients. 52 strains of Gram-negative bacteria accounted for 65.0.The drug resistance rate of Gram-negative bacteria to ceftazidime, cefotaxime, cefepime and levofloxacin was higher. Logistic multiple regression analysis showed that the incidence and time of thoracotomy combined with thoracic infection were higher. The time of indwelling drainage tube, preoperative pulmonary function and postoperative wound contamination were correlated with P0.05.Conclusion the distribution of pathogens, drug resistance and related factors in thoracotomy combined with thoracic infection have some characteristics. Clinicians should pay close attention to it and take intervention measures and select sensitive antibiotics for treatment in order to improve the effect of prevention and control of nosocomial infection and reduce the drug resistance of pathogenic bacteria.
【作者單位】： 連云港市第一人民醫(yī)院胸外科;
【基金】：江蘇省科學(xué)計劃研究基金資助項目(20150138)
【分類號】：R561;R655

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本文編號：1633559