老年腹部手术患者肺部感染的围手术期危险因素分析及护理对策  

A multivariate analysis of perioperative risk factors associated with postoperative pneumonia and corresponding nursing among elderly patients with abdominal surgery

作　　者：董明 董彦君 周丽红 

机构地区：[1]秦皇岛市第四医院北区外科护理部,河北秦皇岛066000 [2]秦皇岛市第四医院南区肿瘤二病区护理部,河北秦皇岛066000

出　　处：《西部医学》2015年第1期135-138,共4页Medical Journal of West China

基　　金：秦皇岛市科技支撑计划项目(201302A121)

摘　　要：目的 探讨老年患者腹部手术后肺部感染的围手术期危险因素及护理对策.方法 收集行腹部手术的107例患者为研究对象,根据患者术后至出院期间是否发生肺部感染分为感染组（19例）和对照组（88例）.对可能影响患者术后发生肺部感染的围手术期危险因素进行单因素和多因素Logistic回归分析.结果 107例患者中,发生肺部感染的患者19例（17.76％）,未发生肺部感染的患者88例（82.24％）.单因素分析提示：感染组患者麻醉时间、手术时间、术中补液量、术中失血量、术后留置鼻胃管时间和上腹部手术比例均大于对照组,差异有统计学意义（P＜0.05）.组间急诊手术、术中气管置管、术后静脉置管分布无差异（P＞0.05）.多因素Logistic回归分析提示：上腹部手术（OR=5.26,95％CI：1.18～23.48）、手术时间长（OR=10.259,95％CI：2.56～41.04）和置胃管时间长（OR=4.00,95％CI：1.68～9.49）是影响老年腹部肿瘤手术术后肺部感染的独立危险因素;并且均会增加术后肺部感染的风险（P＜0.05）.结论 上腹部手术、手术时间长和置胃管时间长可能增加老年腹部手术患者术后肺部感染的风险;采用综合护理措施可降低术后发生肺部感染的风险.Objective To explore the possible perioperative risk factors associate with postoperative pneumonia among elderly patients with abdominal surgery and corresponding nursing advice. Methods 107 elderly patients with abdominal surgery were selected. Clinical data was collected. All patients were divided into pneumonia group and control group according to whether postoperative pneumonia. Perioperative risk factors were analyzed. Results Postoperative pneumonia were observed in 19 patients （17. 76% ）. One way analysis shown that anesthesia time, operation time, intraoperative fluid volume, operative blood loss and nasogastric tube indwelling time and proportion of upper abdominal operation in pneumonia group were significantly greater than those in control group（P〈0.05）. There were no differences between two groups in patient＇s emergency operation or not, tracheal intubation or not, postoperative intravenous catheter or not （P〉0.05）. Logistic regression analysis shown that upper abdominal operation, operation time, nasogastric tube indwelling time were independent risk factors for postoperative pneumonia. Conclusion Upper abdominal operation, longer operation time and nasogastric tube indwelling time can increase the risk of postoperative pneumonia. The comprehen- sive nursing should be performed to reduce the risk of postoperative pneumonia.

关 键 词：肺部感染 围手术期危险因素 术后护理 老年患者 

分 类 号：R473.6[医药卫生—护理学]