發(fā)布時間：2018-06-07 18:38

  本文選題：老年患者全麻插管 + 下呼吸道感染��； 參考：《中華醫(yī)院感染學(xué)雜志》2017年23期

【摘要】：目的探究老年患者全麻插管后下呼吸道感染的病原菌及危險因素與抗感染分析。方法選擇2013年2月-2016年9月于醫(yī)院行全麻氣管插管手術(shù)的老年患者428例為研究對象,對患者發(fā)生下呼吸道感染的相關(guān)因素進(jìn)行觀察和分析;根據(jù)下呼吸道感染發(fā)生時間將感染患者分為序貫組35例和對照組32例,對照組給予頭孢曲松進(jìn)行抗感染治療,序貫組給予頭孢曲松和頭孢克肟進(jìn)行序貫抗感染治療,對兩組患者的抗感染療效進(jìn)行分析;對其痰液進(jìn)行細(xì)菌培養(yǎng),分析其病原菌構(gòu)成。結(jié)果 428例行全麻插管的老年患者中有67例出現(xiàn)下呼吸道感染,感染發(fā)生率為15.65%;感染患者的痰液樣本中共分離出81株病原菌,以革蘭陰性菌為主,共65株占80.25%;序貫組抗感染的總有效率和細(xì)菌清除率分別為91.43%、91.43%,均高于對照組的78.13%、71.88%(P0.05);且序貫組患者的退熱時間、咳嗽緩解時間、咳痰緩解時間及肺Up音消失時間均低于對照組(P0.05);序貫組的不良反應(yīng)發(fā)生率為5.71%,低于對照組的25.00%(P0.05)。結(jié)論針對相關(guān)因素進(jìn)行目標(biāo)性、預(yù)見性干預(yù)和治療,能有效降低相關(guān)感染情況的發(fā)生,應(yīng)用抗菌藥物進(jìn)行序貫治療能夠獲得較好的臨床療效,且臨床用藥安全可靠。
[Abstract]:Objective to investigate the pathogenic bacteria, risk factors and anti-infection analysis of lower respiratory tract infection in elderly patients after intubation under general anesthesia. Methods A total of 428 elderly patients undergoing general anesthesia and tracheal intubation from February 2013 to September 2016 were selected as study subjects. The related factors of lower respiratory tract infection were observed and analyzed. According to the time of occurrence of lower respiratory tract infection, the patients were divided into sequential group (n = 35) and control group (n = 32). The control group was treated with ceftriaxone and ceftriaxone, and the sequential group with ceftriaxone and cefixime was given sequential anti-infection therapy. The antiinfective efficacy of the two groups was analyzed, and the bacterial culture of sputum was carried out to analyze the pathogenic bacteria composition of the sputum. Results among 428 elderly patients undergoing general anesthesia intubation, 67 cases had lower respiratory tract infection, the incidence of infection was 15.65%, 81 strains of pathogenic bacteria were isolated from sputum of infected patients, mainly Gram-negative bacteria. The total effective rate and bacterial clearance rate of the sequential group were 91.43 and 91.43, respectively, which were higher than that of the control group (78.1388 and 71.88), and the antipyretic time and cough relief time of the sequential group were higher than that of the control group, and the total effective rate and bacterial clearance rate of the sequential group were 91.43 and 91.43, respectively. The remission time of expectoration and the time of disappearance of pulmonary up sound were lower than those of control group (P 0.05), and the incidence of adverse reactions in sequential group was 5.71, which was lower than that in control group (25.00%). Conclusion targeted, predictive intervention and treatment for related factors can effectively reduce the incidence of related infections. Sequential treatment with antimicrobial agents can obtain better clinical efficacy, and the clinical use of drugs is safe and reliable.
【作者單位】： 聊城市第二人民醫(yī)院麻醉科;聊城市第二人民醫(yī)院介入診療室;
【基金】：山東省自然基金資助項(xiàng)目(2013ZRB14309)
【分類號】：R614

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