气管插管全麻术后医院内肺部感染的危险因素分析  

Risk factors for nosocomial pulmonary infection after tracheal intubation under general anesthesia

作　　者：蔡小晖 

机构地区：[1]兰溪市人民医院麻醉科,浙江兰溪321100

出　　处：《中华医院感染学杂志》2011年第9期1780-1782,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨气管插管全麻手术后,引起医院内肺部感染的危险因素。方法回顾性分析2006年6月-2010年9月,医院气管插管全麻手术后,引起医院内肺部感染121例患者的临床资料,选取影响肺部感染相关因素进行logistic回归分析。结果年龄>60岁、长期吸烟史、开胸手术、全身麻醉时间>4 h、无术后镇痛、术后气管导管留置时间>2 h的患者,术后肺部感染发生率明显增高,与组内比较,差异有统计学意义(P<0.05);多因素分析表明,年龄>60岁(P=0.000,R=4.317)、长期吸烟史(P=0.003,R=2.226)、开胸手术(P=0.000,R=12.813)、全身麻醉时间>4 h(P=0.046,R=2.634)、无术后镇痛(P=0.032,R=2.419)、术后气管导管留置时间>2 h(P=0.000,R=1.486)是术后肺部感染独立影响因素。结论气管插管全麻手术后,医院内肺部感染和多种因素有关,年龄>60岁、长期吸烟史、开胸手术、全身麻醉时间>4 h、无术后镇痛、术后气管导管留置时间>2 h为术后肺部感染的独立因素,对上述因素干预有助于医院内肺部感染的预防与控制。OBJECTIVE To investigate the risk factors of nosocomial pulmonary infection after tracheal intubation under general anesthesia.METHODS Clinical data of 121 cases with nosocomial pulmonary infection who had tracheal intubation under general anesthesia from Jun.2006 to Nov.2010 were analyzed retrospectively.Related risk factors were chosen and multifactor logistic regression analysis was made.RESULTS Using univariate analysis,the age〉60 y,gender,disease diagnosis,main complications,operative site,duration of ventilation,recovery time after operation,delayed extubation,using muscle relaxant,preoperative amount of white blood cells,preoperative hypoproteinemia,smoking status,preoperative lung function and and the time that the patients start coughing after the operation showed significant correlation to nosocomial pulmonary infection（P〈0.05）.Multivariate analysis showed that the age（P=0.000,R=4.317）,smoking status（P=0.003,R=2.226）,openning chest surgery（P=0.000,R=12.813）,general anaesthesia time（P=0.046,R=2.634）,postoperative analgesia（P=0.032,R=2.419）and tracheal catheter time 〉2h（P=0.000,R=1.486）were the important related risk factors of nosocomial pulmonary infection.CONCLUSION There are many impact factors that the nosocomial pulmonary infection resulting from the operation with tracheal intubation under general anesthesia.The main risk factors are age,complications of the disease,ventilation time,postoperative recovery time,smoking status and the time that the operated patients start coughing after the operation,which are helpful for nosocomial infection control.

关 键 词：气管插管 全麻手术 肺部感染 影响因素 

分 类 号：R181.32[医药卫生—流行病学]