麻醉机内部呼吸回路污染危险因素分析  

Analysis of risk factors of respiratory circuit pollution in anesthesia machine and its management countermeasures

作　　者：韩慧娟[1] 邵沂 王佳[1] HAN Hui-juan;SHAO Yi;WANG Jia(Department of Anesthesiology,Children's Hospital Affiliated to Zhengzhou University,Henan Children's Hospital,Zhengzhou Children's Hospital ,Zhengzhou450000,P.R.China)

机构地区：[1]郑州大学附属儿童医院.河南省儿童医院.郑州儿童医院麻醉科,河南郑州450000

出　　处：《社区医学杂志》2018年第16期1304-1307,共4页Journal Of Community Medicine

摘　　要：目的麻醉机内部呼吸回路污染为引起院内交叉感染主要因素,严重影响医疗安全,分析导致麻醉机内部呼吸回路污染危险因素并针对性进行管理,对降低麻醉机内部呼吸回路污染有重要价值。本研究探讨麻醉机内部呼吸回路污染危险因素,并针对性提出管理干预对策。方法选取2016-07-01-2017-11-01在郑州大学附属儿童医院37台麻醉机上实施手术的722例患者作为研究对象,每天术后对麻醉机内部呼吸回路进行采样细菌检测,将麻醉机污染当天实施手术患者作为污染组,其余患者作为对照组,收集两组患者可疑危险因素信息,分析导致麻醉机内部呼吸回路污染危险因素,并针对性提出护理预防和干预对策。结果 37台麻醉机共发生污染20台,占54. 05%,涉及手术患者112例,共培养出病原菌54株,其中革兰阴性菌38株,占70. 37%,革兰阳性菌16株,占29. 63%。单因素分析显示,年龄(t=8. 136,P=0. 001)、手术方式(χ~2=5. 727,P=0. 017)、气管插管(χ~2=7. 305,P=0. 007)、俯卧位(χ~2=4. 393,P=0. 036)、侧卧位(χ~2=4. 451,P=0. 035)、仰卧位(χ~2=9. 939,P=0. 002)、手术时间(t=9. 927,P=0. 001)、体外循环(χ~2=9. 299,P=0. 002)在污染组和对照组间比较有统计学意义。多因素分析显示,年龄(OR=2. 354,95%CI为1. 214～9. 154,P=0.001)、腔镜手术(OR=2. 164,95%CI为1. 125～11. 547,P=0. 005)、俯卧位(OR=4. 164,95%CI为1. 224～15. 167,P <0. 001)、侧卧位(OR=2. 014,95%CI为1. 064～12. 154,P=0. 008)、手术时间(OR=1. 614,95%CI为1. 047～8. 164,P=0. 019)为影响麻醉机内部呼吸回路污染危险因素。结论影响麻醉机呼吸内部回路污染危险包括年龄、腔镜手术、俯卧位、侧卧位和手术时间等,针对相关危险因素实施护理干预对降低污染发生率有重要意义。OBJECTIVE The internal respiratory circuit pollution of the anesthesia machine is the main cause of crossinfection in the hospital,which seriously affects the safety of medical treatment. Analysing the risk factors causing internal respiratory circuit pollution in the anesthesia machine and performing targeted management has important value in reducing the internal respiratory circuit pollution of the anesthesia machine. This study aims to investigate the risk factors of internal respiratory circuit pollution in anesthesia machines,and to propose management intervention measures. METHODS A total of 722 patients undergoing surgery on 37 anesthesia machines from July 1,2016 to November 1,2017 in Children’s Hospital Affiliated to Zhengzhou University were selected as research subjects,the bacteria in the internal respiratory circuit of the anesthesia machine were sampled every day after the operation. The surgical patients on the day of the anesthesia machine contamination were used as the contaminated group. The rest of the patients were used as the control group. The information on the suspicious risk factors of the two groups of patients was collected to analyze the risk factors of internal respiratory circuit pollution in the anesthesia machine,and targeted prevention and intervention measures. RESULTS A total of 20( 54. 05%) of 37 anesthesia machines were contaminated,involving 112 surgical patients. 54 strains of pathogenic bacteria were cultured,including 38 strains of Gram-negative bacteria( 70. 37%) and 16 strains of Gram-positive bacteria( 29. 63%). The single factor analysis showed that age( t = 8. 136,P = 0.001),surgical approach( χ~2= 5. 727,P = 0. 017),tracheal intubation( χ~2= 7. 305,P = 0. 007),prone position( χ~2= 4. 393,P = 0.036),lateral position( χ~2= 4. 451,P = 0. 035),supine position( χ~2= 9. 939,P = 0. 002),operation time( t = 9. 927,P = 0. 001),and extracorporeal circulation( χ~2= 9. 299,P = 0. 002) were statistically significant between the two groups. Multi-factors logistic regressi

关 键 词：麻醉机 呼吸回路 污染 危险因素 护理 

分 类 号：R614[医药卫生—麻醉学]