老年患者腹部手术全麻后肺部感染的原因分析  

Causes of pulmonary infections in elderly patients undergoing abdominal surgery under general anesthesia

作　　者：王开娟[1] 赵利芳[1] 

机构地区：[1]新乡市中心医院麻醉科,河南新乡453000

出　　处：《中华医院感染学杂志》2013年第20期4919-4921,共3页Chinese Journal of Nosocomiology

基　　金：新乡市科研基金项目(20120412)

摘　　要：目的探讨老年患者全身麻醉行腹部手术后发生肺部感染的原因,为其临床预防治疗提供参考依据。方法收集2011年5月-2012年5月300例全身麻醉行腹部手术治疗的老年患者临床资料,详细记录其基本信息及相关病史,根据其是否发生肺部感染分为感染组80例与非感染组220例,分析肺部感染发生的原因。结果 300例全身麻醉行腹部手术治疗的老年患者中发生肺部感染患者80例,发生率为26.7%;感染组患者有慢性阻塞性肺疾病、糖尿病史及侵入性操作分别占62.5%、62.5%、56.3%,非感染组分别占40.9%、45.5%、40.9%,手术时间、血清白蛋白水平感染组分别为(2.3±0.8)h、(29.2±3.2)g/L;非感染组分别为(1.5±0.9)h、(36.9±4.2)g/L,各项指标感染组与非感染组患者比较差异有统计学意义(P<0.05);多因素分析结果表明,既往慢性阻塞性肺疾病、糖尿病史、手术时间延长、白蛋白水平低下均为全身麻醉腹部手术后肺部感染发生的独立因素(P<0.05)。结论全身麻醉行腹部手术治疗患者如果患有慢性阻塞性肺疾病、糖尿病、手术时间较长、白蛋白水平较低亦发生肺部感染,对该类患者要积极给予相应的预防干预措施。OBJECTIVE To explore the causes of complicated pulmonary infections＇ in the elderly patients undergoing abdominal surgery under general anesthesia so as to guide the clinical prevention and treatment. METHODS The clinical data of 300 elderly patients who needed the abdominal surgery under general anesthesia from May 2011 to May 2012 were collected, then the general information and related medical history of the participants were recorded in detail, the subjects were divided into the infection group with 80 cases and the non- infection group with 220 cases according to the status of pulmonary infections, and the causes of the pulmonary infections were analyzed. RESULTS Of totally 300 elderly patients who underwent the abdominal surgery under general anesthesia, the pulmonary infections occurred in 80 cases with the incidence rate of 26.7%. Among the patients in the infection group, the patients with chronic obstructive pulmonary disease history, diabetes mellitus history, and invasive operation accounted for 62. 5%, 62. 5%, and 56. 3~, respectively and accounted for 40.9%, 45.5%, and 40.9% in the non-infection group. The operation duration was （2.3±0.8）h in the infection group, （1.5±0.9）h in the non-infection group; the serum albumin level was （29.2±3.2） g/L in the infection group, （36.9±4.2）g/L in the non-infection group; the difference in the various indicators between the infection group and the non-infection group was significant（P〈0.05）. The multivariate analysis indicated that the COPD history, diabetes history, prolonged operation duration, and low albumin level were the independent factors for the postoperative pulmonary infections（P^0.05）. CONCLUSION It is necessary to take corresponding prevention interventions for the patients undergoing abdominal surgery under general anesthesia who are complicated with COPD, diabetes, prolonged operation duration , or low albumin level.

关 键 词：全身麻醉 腹部手术 老年 肺部感染 危险因素 

分 类 号：R563.1[医药卫生—呼吸系统]