胸外科手术后医院获得性肺炎危险因素分析  

Risk factors of hospital-acquired pneumonia after thoracic surgery

作　　者：许缤[1] 陈红岩[1] 孙嫣[1] 仝宇红 朱丽丽[2] 陈大华[1] 

机构地区：[1]石家庄市第一医院感控处,河北石家庄050011 [2]石家庄市第一医院骨科,河北石家庄050011

出　　处：《中华医院感染学杂志》2012年第1期64-66,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨胸外科手术后患者医院获得性肺炎的危险因素,为制定医院感染控制措施提供理论依据。方法采用目标性监测的方法对2009年4月-2010年4月胸外科住院手术的312例患者,术后医院获得性肺炎发病率及相关危险因素进行调查分析。结果 312例胸外科手术患者单因素分析,发现长期大量吸烟史、慢性支气管炎肺气肿病史、手术方式、手术时间、气管插管/机械通气、术后切口疼痛明显与术后医院获得性肺炎有显著的关联(P<0.05),而年龄、住院时间与术后医院获得性肺炎的发生无显著关联;多因素分析筛选出4个术后医院获得性肺炎的相关因素:长期大量吸烟史、慢支肺气肿病史、术后切口疼痛明显、气管插管/机械通气,差异有统计学意义(P<0.05)。结论长期大量吸烟史、慢支肺气肿病史、术后切口疼痛明显、气管插管/机械通气,是胸外科手术后患者医院获得性肺炎的危险因素;针对危险因素采取有效控制措施,是控制医院获得性肺炎的关键。OBJECTIVE To study the risk factors of hospital-acquired pneumonia in thoracic surgical patients and provide the theoretical basis for the establishment of hospital infection control measures. METHODS Through target-surveillance, we studied the postsurgical incidence rate and relative risk factors of 312 hospital-acquired pneumonia patients who were hospitalized in the thoracic surgery department from Apr. 2009 to Apr. 2010. RESULTS Through single factor analysis of the 312 thoracic surgical patients, we found that a long history of heavy smoking, emphysema and chronic bronchitis history, surgical procedure, operation time, trachea intubation/mechanical ventilation, and obviously postoperative incision pain were significantly associated with postsurgical acquired pneumonia （P 〈 0. 05 ）, whereas no significant association was found with age, hospitalization time （P〉0. 05）. Multivariate analysis established four factors relevant to postsurgical acquired pneumonia with significant differences （P〈0. 05）： a long history of heavy smoking, emphysema and chronic bronchitis history, obvious postoperative incision pain and trachea intubation/mechanical ventilation. CONCLUSION A long history of heavy smoking, emphysema and chronic bronchitis history, obvious postoperative incision pain and trachea intubation/mechanical ventilation are the main risk factors of hospital acquired pneumonia in thoracic surgical patients. Taking effective control of those risk elements is the key to manage hospital-acquired pneumonia.

关 键 词：胸外科手术 医院获得性肺炎 危险因素 

分 类 号：R181.32[医药卫生—流行病学]