术前鼻腔干预对经鼻气管插管全身麻醉患者术后预防下呼吸道感染的评价  

Evaluation of prevention effect of preoperative nasal intervention program on lower respiratory tract infections in patients treated with general anesthesia by nasal intubation

作　　者：刘江梅[1] 丁彬[1] 徐永华[2] 郑君[1] 张安美[1] 

机构地区：[1]潍坊市人民医院麻醉科,山东潍坊261041 [2]潍坊市人民医院放疗科,山东潍坊261041

出　　处：《中华医院感染学杂志》2016年第5期1118-1120,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(1400171148)

摘　　要：目的探讨术前鼻腔干预措施对气管插管全身麻醉手术患者术后下呼吸道感染的预防效果,为预防患者术后下呼吸道感染提供依据。方法 2013年6月-2015年6月行气管插管全身麻醉择期手术治疗的920例患者为研究对象,采用随机数字表法将患者随机分为观察组和对照组,每组各460例;对照组患者给予常规术前准备,干预组在对照组基础上给予35~38℃温生理盐水进行悬挂式鼻腔冲洗,0.1%聚维酮碘行鼻腔消毒等鼻腔干预措施,观察两组患者术后下呼吸道感染的发生率和病原菌分布。结果观察组患者下呼吸道感染率为4.57%,显著低于对照组的7.83%,差异有统计学意义（χ2=4.208,P〈0.05）;观察组21例下呼吸道感染患者检测出病原菌25株,对照组36例下呼吸道感染患者检测出病原菌49株,两组均以肺炎克雷伯菌及金黄色葡萄球菌为主要病原菌;观察组下呼吸道感染患者的平均住院天数、住院费用显著低于对照组下呼吸道感染者,差异均有统计学意义（P〈0.05）。结论术前给予经鼻气管插管全身麻醉手术患者鼻腔冲洗及消毒等干预措施,可以有效预防术后下呼吸道感染的发生。OBJECTIVE To evaluate the prevention effect of preoperative nasal intervention program on low respiratory tract infections in patients treated with general anesthesia by nasal intubation,so as to provide the basis for the prevention of postoperative lower respiratory tract infections.METHODS Totally 920 patients with endotracheal intubation general anesthesia for selective surgery from Jun.2013 to Jun.2015 in our hospital were selected for the study.Patients were randomly divided into the observation group and the control group by random number table,460 cases in each group.The control group received routine preoperative preparation.The intervention group was given warm saline（35-38 ℃）for suspended nasal irrigation and 0.1% povidone-iodine to disinfect nasal on basis of treatment in the control group.The incidence of lower respiratory tract infection and clinical symptoms were observed and pathogen distribution was analyzed for the two groups.RESULTS The incidence of lower respiratory tract infection was 4.57%in the observation group,significantly lower than 7.83%in the control group（χ^2= 4.208,P〈0.05）.Totally 25 pathogens were detected in 21 cases with lower respiratory tract infection in the observation group,and 49 pathogens were detected in 36 patients with lower respiratory tract infection in the control group.Klebsiella pneumoniae and Staphylococcus aureus were the main pathogens in both groups.The average length of stay and hospitalization costs of patients with lower respiratory tract infection were significantly lower in the observation group than in the control group（P〈0.05）.CONCLUSIONPreoperative nasal interventions such as nasal irrigation and disinfection can be effective in preventing lower respiratory tract infection in general anesthesia patients with nasotracheal intubation.

关 键 词：鼻腔 干预措施 下呼吸道感染 气管插管 

分 类 号：R614[医药卫生—麻醉学]