本文選題：手術(shù)室 + 護(hù)理��； 參考：《中華醫(yī)院感染學(xué)雜志》2017年16期

【摘要】：目的探討影響心臟搭橋手術(shù)患者術(shù)后感染因素,并制定預(yù)防措施。方法選擇2013年6月-2016年6月在醫(yī)院接受心臟搭橋手術(shù)治療的3 498例患者,采集術(shù)后感染患者血液、傷口分泌物、尿液、咽拭子、組織液等標(biāo)本進(jìn)行細(xì)菌培養(yǎng)、鑒定及藥敏試驗(yàn),并對(duì)影響心臟搭橋手術(shù)患者術(shù)后感染因素進(jìn)行分析。結(jié)果 3 498例患者中有96例發(fā)生術(shù)后感染,感染率為2.74%;感染部位以手術(shù)切口為主,共分離出128株病原菌,其中革蘭陽性菌41株占32.03%,革蘭陰性菌74株占57.81%,真菌13株占10.16%;金黃色葡萄球菌、糞腸球菌、表皮葡萄球菌對(duì)青霉素G、紅霉素的耐藥率50.00%,而對(duì)萬古霉素、利奈唑胺非常敏感;銅綠假單胞菌、大腸埃希菌、肺炎克雷伯菌對(duì)氨芐西林、頭孢曲松具有較高耐藥率,對(duì)頭孢他啶、左氧氟沙星耐藥率50.00%,對(duì)亞胺培南、美羅培南、頭孢哌酮/舒巴坦非常敏感;年齡≥60歲、有合并癥、二次手術(shù)、術(shù)中出血量≥1 200ml、手術(shù)時(shí)間5h、術(shù)前住院時(shí)間≥7d、胸腔引流時(shí)間≥3d、氣管插管時(shí)間≥3d、導(dǎo)尿管留置時(shí)間≥3d、心功能NYHA≥Ⅲ級(jí)、切口實(shí)施皮下連續(xù)縫合、未預(yù)防性使用抗菌藥物是心臟搭橋手術(shù)術(shù)后感染的獨(dú)立危險(xiǎn)因素。結(jié)論多種因素均可引起心臟搭橋手術(shù)患者術(shù)后感染,針對(duì)相關(guān)因素應(yīng)積極采取有效預(yù)防對(duì)策,以降低術(shù)后感染率。
[Abstract]:Objective to investigate the factors affecting postoperative infection in patients undergoing cardiac bypass grafting and to make preventive measures. Methods from June 2013 to June 2016, 3 498 patients underwent cardiac bypass surgery in hospital. Blood, wound secretion, urine, pharynx swab and tissue fluid were collected for bacterial culture, identification and drug sensitivity test. The influencing factors of postoperative infection in patients undergoing cardiac bypass grafting were analyzed. Results 96 out of 3 498 patients had postoperative infection, the infection rate was 2.74.The infection site was mainly surgical incision, 128 strains of pathogenic bacteria were isolated. Among them, 41 Gram-positive bacteria accounted for 32.03, 74 Gram-negative bacteria accounted for 57.81 and 13 fungi accounted for 10.16.The resistance rate of Staphylococcus aureus, Enterococcus faecalis, Staphylococcus epidermidis to penicillin G and erythromycin was 50.00. Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae showed high resistance to ampicillin and ceftriaxone, and 50.00to ceftazidime and levofloxacin, sensitive to imipenem, meropenem, cefoperazone / sulbactam; Age 鈮，

本文編號(hào)：2044524