肝脏移植患者术后肺部感染的危险因素分析  

The analyze of potential risk factors of postoperative pulmonary infection in patients undergoing liver transplantation

作　　者：段敏[1] 

机构地区：[1]第三军医大学西南医院全军肝胆外科研究所,重庆市400038

出　　处：《中华护理杂志》2002年第8期574-576,共3页Chinese Journal of Nursing

摘　　要：目的 :分析肝脏移植患者术后肺部感染的可能危险因素 ,探讨防治措施。方法 :采用回顾性调查 ,对 1 9例肝脏移植患者的相关资料进行单因素和多因素回归分析。结果 :术后呼吸机使用时间≥ 2天的患者发生院内肺炎的危险性为 <2天者的1 1 .2 5倍 ,气管切开、接受纤维支气管镜检查的患者的危险性均接近 6倍。胃管留置时间长者发生肺部感染的危险性为其他患者的 4 .8倍 ,术前大量腹水和术后肺水肿两者造成肺部感染的相对危险度分别为 5 .5倍和 4 .0倍。结论 :术前大量腹水、肾功能异常 ,术后呼吸机使用时间、气管切开、留置胃管时间、肺水肿、纤维支气管镜检查或治疗与术后肺部感染相关。术后肺部感染按相对危险度大小依次为 :术后使用呼吸机≥ 2天、长时间手术、术后纤维支气管镜检查或治疗、术后气管切开、术前大量腹水、术后长时间留置胃管、术后肾功能异常。Objecteve:To analyze the potential risk factors of postoperative pulmonary infection in patients undergoing liver transplantation, so as to explore the feasible treatment measures.Methods: 19 patients with liver transplantation were enrolled in this retrospective study in terms of the incidence of postoperative pulmonary infection. Single factor and multiple factors regression were used to analyze the data.Results: The incidence of the pulmonary infection in the patients who underwent respiratory support for more than 2 days was 11.25 times of that in those less than 2 days. While the incidences in patients receiving tracheostomy and/or fibrobronchoscope were 6 times higher. Moreover, gastric intubation for a longer time could cause the infection 4.8 times more. The relative risks in those with preoperative excessive ascites or postoperative pulmonary edema were 5.5 and 4 times higher than those controls, respectively.Conclusion: The risk factors of postoperative pulmonary infection in patients undergoing liver transplantation included preoperative excessive ascites, tracheostomy, postoperative respiratory support, gastric intubation, abnormal renal function, postoperative pulmonary edema and fibrobronchoscope examination.

关 键 词：肝移植 手术后并发症 危险因素 肺部感染 

分 类 号：R619[医药卫生—外科学]