气管插管全麻术后医院内呼吸道感染的影响因素  

Impact Factors on Nosocomial Respiratory Tract Infections after Operations under General Anesthesia with Tracheal Intubation

作　　者：叶丹[1] 卢次勇[1] 李莲娜[1] 黄君瑶[1] 林红燕[1] 

机构地区：[1]广州医学院第一附属医院医院感染管理科,广东广州510120

出　　处：《中华医院感染学杂志》2009年第19期2543-2545,共3页Chinese Journal of Nosocomiology

基　　金：广东省科技厅项目(2005B30601020)

摘　　要：目的探讨气管插管全麻手术后引起医院内呼吸道感染的相关影响因素,为降低医院感染率制定防治策略提供科学的依据。方法采用描述性流行病学和病例对照研究方法,选择近3年气管插管全麻手术后引起医院内呼吸道感染患者180例和非医院内呼吸道感染患者180例进行调查分析。结果调查2005-2007年5923例气管插管全麻手术患者的医院感染率为10.10%,呼吸道感染率为5.25%,在医院感染的构成比中,呼吸道感染位居首位,占52.00%;多因素Logistic回归分析结果显示,气管插管全麻手术后医院内呼吸道感染的7个影响因素的差异有统计学意义(P<0.05,OR>1)。结论气管插管全麻手术后引起医院内呼吸道感染(尤其下呼吸道感染)是多因素的,主要危险因素是年龄、并发症、手术状态、气管插管麻醉通气时间、术后苏醒时间、吸烟状况、手术后开始咳嗽的时间,因此气管插管全麻手术后医院内呼吸道感染的预防与控制尤为重要。OBJECTIVE To probe into the impact factors of the nosocomial respiratory tract infections after the operations with tracheal intubation under general anesthesia in order to establish the prevention and treatment strategies and provide the scientific basis. METHODS By descriptive epidemiological method and case-control study method, 80 cases with nosocomial respiratory tract infections in nearly 3 years who had tracheal intubation under general anesthesia were selected, and another 180 patients with non-nosocomial respiratory tract infections with tracheal intubation under general anesthesia were selected as the control. RESULTS The incidence of the nosocomial infections from 5923 patients of the operation with tracheal intubation under general anesthesia from 2005 to 2007 accounted for 10.1%. The incidence of the respiratory tract infections of operations under general anesthesia accounted for 5. 25%. The nosocomial respiratory tract infection from the tracheal intubation under general anesthesia toped the list and accounted for 52.0%. It showed seven impact factors on the nosocomial respiratory tract infection after the operation with tracheal intubation under general anesthesia by the multi-factorial Logistic regression, respectively, with significant differences （P^0.05, ORal）. CONCLUSIONS There are many impact factors that the nosocornial respiratory tract infection （especially lower respiratory tract infection） resulting from the operation with tracheal intubation under general anesthesia. The study shows the main risk factors： age, the complications of the disease, surgical condition, the ventilation time of tracheal intubationunder the anesthesia, post-operative recovery time, smoking status, the time that the operated patients start coughing after the operation. Therefore, the prevention is especially important.

关 键 词：气管插管全麻手术 医院内呼吸道感染 影响因素 

分 类 号：R181.32[医药卫生—流行病学]