不同干预方法对麻醉机通气系统病原微生物的影响  

Effects of Different Intervention Methods on Pathogenic Microorganisms in Anesthesia Machine Ventilation System

作　　者：张玮[1] 万福红[1] 梁宁[1] 

机构地区：[1]广西壮族自治区人民医院麻醉科,南宁市530021

出　　处：《广西医学》2014年第12期1737-1740,共4页Guangxi Medical Journal

基　　金：广西医药卫生科研课题(重2011111)

摘　　要：目的观察麻醉机通气系统病原微生物的定植特点,探讨不同干预途径下对麻醉机通气系统病原微生物的影响。方法选择择期全麻插管手术患者150例,按随机数字表法分为未干预组(A组)、麻醉消毒机组(B组)及呼吸过滤器组(C组),每组各50例,B组在麻醉开始前使用麻醉消毒机消毒麻醉机内部回路,C组在气管导管与一次性呼吸回路之间放置呼吸过滤器。麻醉前后采集呼吸环路及呼吸过滤器标本进行细菌培养;并对患者进行术后随访,观察肺部感染发生情况。结果麻醉机呼吸环路定植的主要为条件致病菌。麻醉结束后,B组麻醉机吸气端、呼气端及储气囊端口的病原菌阳性检出率明显低于A组(P<0.05),C组各端口的检出率与A组相似(P>0.05),C组呼吸过滤器患者面菌落阳性率明显高于呼吸环路面(P<0.05)。B组、C组术后肺部感染发生率均低于A组(P<0.05)。结论使用麻醉消毒机或呼吸过滤器均可降低全麻插管患者术后呼吸道感染发生率。Objective To observe the colonization characteristics of pathogenic microorganisms in the anesthesia machine ventilation system,and to explore the effect of different intervention approaches on pathogenic microorganisms in the anesthesia machine ventilation system. Methods A total of 150 patients who received general intubation anesthesia were randomly divided into three groups,non-intervention group（ group A）,disinfection machine group（ group B） and respiratory filter group（ group C）,with 50 cases in each group. The disinfected machines were used in group B before anesthesia,and respiratory filters were used in group B. The samples were taken from breathing circuit and respiratory filter for bacterial culture before and after anesthesia. The patients with lung infection were followed up after operation.Results The most common bacteria in the breathing circuit of anesthesia machine was conditional pathogenic bacteria.After anesthesia,the positive rates of the bacteria in the expiration port,inpiration port and gasbag port of anesthesia machine in group B were significantly lower than those in group A（ P〈0. 05）. The positive rates of the bacteria in each port in group C were similar with those in group A（ P〉0. 05）. The positive rate of the bacteria on the side of patient was significantly higher than that on the breathing circuit in the respiratory filter（ P〈0. 05）. The incidences of lung infection after operation in group B and group C were lower than that in group A（ P〈0. 05）. Conclusion The incidence of lung infection after operation can be significantly reduced with the application of the disinfection machine or breathing filter in patients undergoing general intubation anesthesia.

关 键 词：麻醉机 麻醉消毒机 呼吸过滤器 病原微生物 

分 类 号：R613[医药卫生—外科学]