手术麻醉患者呼吸道感染的相关性研究  

Related factors for respiratory tract infections in patients undergoing surgical anesthesia

作　　者：崔乃荣[1] 贾珍[1] 王建民[1] 

机构地区：[1]青海大学附属医院麻醉科,青海西宁810001

出　　处：《中华医院感染学杂志》2015年第9期2058-2059,2065,共3页Chinese Journal of Nosocomiology

基　　金：教育部高校博士点基金资助项目(200802481094)

摘　　要：目的探讨呼吸道感染与麻醉相关因素,为临床应用提供理论依据。方法选取2011年10月-2014年1月手术麻醉患者570例,基于患者是否发生感染分为感染组320例和非感染组250例,对气管插管麻醉相关因素实施相关性分析,分析因素包括喉镜消毒方式、过滤器类型、抗菌药物使用、插管等;采用SPSS16.0软件进行统计分析,计数资料采取χ2检验。结果盲深插管、拔管延迟且<3h为感染非相关因素,OR值均<2.00,对比差异无统计学意义;感染相关性因素为喉镜消毒方式(OR=3.56,χ2=37.51)、过滤器类型(OR=4.21,χ2=44.58)、抗菌药物使用(OR=2.11,χ2=14.15)、插管过深(OR=2.14,χ2=13.73)、插管不熟练(OR=2.10,χ2=15.08)、拔管指征不完全(OR=2.21,χ2=24.97)、拔管延迟且>3h(OR=3.41,χ2=34.89),对比差异有统计学意义;感染组患者共培养分离出395株病原菌,以革兰阴性菌为主,占58.61%。结论引发气管插管麻醉患者呼吸道发生感染的相关危险因素较多,需要引起注意,针对性预防,降低感染率。OBJECTIVE To explore the related factors for the anesthesia‐induced respiratory tract infections so as to provide theoretical basis for clinical application .METHODS A total of 570 patients who underwent the surgical an‐esthesia from Oct 2011 to Jan 2014 were enrolled in the study and divided into the infection group with 320 cases and the non‐infection group with 250 cases according to the status of infections ,then the related factors for endo‐tracheal intubation anesthesia ,including the laryngoscope disinfection ,types of the filter ,use of antibiotics ,and intubation ,were analyzed ,the statistical analysis was performed with the use of SPSS16 .0 software ,and the count data were analyzed by using the chi‐square test .RESULTS The blind deep intubation and delay of extubation less than 3 hours were not the related factors ,the OR values were less than 2 .00 ,and the differences were not significant .The related factors for the infections included the laryngoscope disinfection（OR=3 .56 ,χ2 = 37 .51） , types of the filter（OR=4 .21 ,χ2 =44 .58） ,use of antibiotics（OR=2 .11 ,χ2 =14 .15） ,too deep intubation （OR=2 .14 ,χ2 =13 .73） ,unskilled intubation （OR= 2 .10 ,χ2 = 15 .08） ,incomplete indications for extubation （OR=2 .21 ,χ2 =24 .97） ,and delay of extubation more than 3 hours ,as compared with these related factors ,the differ‐ences were significant .Totally 395 strains of pathogens have been isolated from the patients in the infection group , among which the gram‐negative bacteria accounted for 58 .61% .CONCLUSION There are a variety of related risk factors for the respiratory tract infections in the patients undergoing endotracheal intubation anesthesia ,which should be paid attention to .It is necessary to take targeted prevention measures to reduce the incidence of infec‐tions .

关 键 词：呼吸道 感染 麻醉 相关因素 

分 类 号：R562.1[医药卫生—呼吸系统]