老年患者开胸术后肺部感染的临床分析及干预措施  

Clinical analysis and intervention of pulmonary infections in elderly patients after thoracotomy

作　　者：刘晓来[1] 朱勇[2] 崔建娇[3] 

机构地区：[1]辽宁医学院附属第三医院护理部,辽宁锦州121001 [2]辽宁医学院附属第三医院ICU,辽宁锦州121001 [3]辽宁医学院附属第三医院检验科,辽宁锦州121001

出　　处：《中华医院感染学杂志》2014年第15期3788-3790,共3页Chinese Journal of Nosocomiology

基　　金：辽宁省卫生厅基金资助项目(LW-2010B-1017)

摘　　要：目的探讨老年患者开胸术后肺部感染主要病原菌耐药性,危险因素以及痰热清注射液的临床效果,以便提高该病的临床治疗水平。方法选取2010年4月-2013年2月180例老年行开胸手术患者为研究对象,对肺部感染的患者进行病原菌耐药性分析,并探讨其危险因素,采用痰热清注射液进行治疗,分析其临床治疗效果,采用SPSS13.0软件进行分析。结果 180例老年开胸术后患者发生肺部感染41例,感染率为22.78%,41例感染患者分离出病原菌46株,以铜绿假单胞菌最多,占34.78%;危险因素有高龄(>70岁)、痰潴留、存在多种基础疾病、手术时间长(>20d)、住院时间长(>30d)、肺功能低下、淋巴结清扫、吸烟、侵入性操作;经过痰热清等对症治疗后,总有效率为95.12%,且临床症状等缓解明显。结论老年患者开胸术后肺部感染因素错综复杂,痰热清注射液对肺部感染临床效果显著。OBJECTIVE To investigate resistance of major pathogens and risk factors of pulmonary infections in elderly patients after thoracotomy and clinical efficacy of treatment with Tanreqing injection, in order to improve clinical treatment level for the disease. METHODS Totally 180 elderly patients undergoing thoracotomy during Apr. 2010-Feb. 2013 were chosen as the research subjects, pathogen resistance analysis was conducted for those who experienced pulmonary infections, and the risk factors for the infection were explored. Tanreqing injection was used for treatment of infections, and its clinical effect was analyzed with SPSS 13.0 software. RESULTS In 180 cases of elderly patients after thoracotomy, there were 41 cases of pulmonary infections, the infection rate was 22.78%. For pathogen distribution, 41 patients were isolated with 46 pathogens, predominant by Pseudoinonas aeruginosa, accounting for 34.78%. Risk factors included advanced age （〉70 years）, sputum retention, a variety of underlying diseases, surgery for a long time （〉 20 d）, length of hospital stay （〉30 d）, pulmonary hypofunction, lymph node dissection, smoking and invasive operation. With Tanreqing injection and other symptomatic treatment, the total effective rate was 95. 12%, and the remission of clinical symptoms was significant. CONCLUSION There were complicated factors for pulmonary infections in elderly patients after thoracotomy. Tanreqing injection showed significant clinical effect for pulmonary infections.

关 键 词：老年 开胸手术 肺部感染 危险因素 

分 类 号：R563[医药卫生—呼吸系统]