【摘要】：目的研究老年患者在全身麻醉術后呼吸道感染的發(fā)病率、病原學特點及危險因素,為積極預防提供參考。方法選擇2014年2月-2016年12月在醫(yī)院行全身麻醉后的486例老年患者,回顧性分析臨床資料,探究呼吸道感染率及病原學特點,調查患者性別、年齡、吸煙史、肺部手術史、麻醉時間、插管途徑、拔管時間、喉鏡消毒方式、術前抗菌藥物或激素使用、糖尿病、慢性呼吸系統(tǒng)疾病及術后使用呼吸機等基本情況,對呼吸道感染的危險因素進行單因素及多因素分析。結果呼吸道感染患者63例,感染率12.96%,痰培養(yǎng)檢出病原菌64株,主要為肺炎克雷伯菌20株占31.25%、銅綠假單胞菌19株占29.69%、鮑氏不動桿菌16株占25.00%,金黃色葡萄球菌9株占14.06%;多因素logistic回歸分析結果顯示,年齡≥65歲、有吸煙史或肺部手術史、麻醉時間≥2.5h、經(jīng)口氣管插管、拔管時間≥2h、普通喉鏡消毒方式、術前使用抗菌藥物或激素、有糖尿病或慢性呼吸系統(tǒng)疾病、術后使用呼吸機等是老年患者全身麻醉后呼吸道感染的獨立危險因素(P0.05)。結論年齡、吸煙、肺部手術、麻醉時間、插管方式、喉鏡消毒方式、使用呼吸機、使用抗菌藥物以及合并慢性呼吸系統(tǒng)疾病等為老年患者全麻后呼吸道感染的獨立危險因素,并證實了以肺炎克雷伯菌感染多見的病原學特點,由此形成有效的預防控制感染措施。
[Abstract]:Objective to study the incidence, etiological characteristics and risk factors of respiratory tract infection in elderly patients after general anesthesia. Methods A total of 486 elderly patients undergoing general anesthesia in hospital from February 2014 to December 2016 were selected. The clinical data were retrospectively analyzed, the respiratory tract infection rate and etiological characteristics were investigated, gender, age, smoking history, history of lung surgery were investigated. Anesthesia time, intubation pathway, extubation time, laryngoscope disinfection, preoperative use of antibiotics or hormones, diabetes mellitus, chronic respiratory diseases and postoperative use of respirators, etc. The risk factors of respiratory tract infection were analyzed by univariate and multivariate analysis. Results there were 63 cases of respiratory tract infection, the infection rate was 12.96%, 64 strains of pathogenic bacteria were detected in sputum culture. Twenty strains of Klebsiella pneumoniae accounted for 31.25%, 19 strains of Pseudomonas aeruginosa accounted for 29.69%, 16 strains of Acinetobacter baumannii accounted for 25.00% and 9 strains of Staphylococcus aureus accounted for 14.06%. Multivariate logistic regression analysis showed that the age of 鈮，

本文編號：2219999