腹部外科术后患儿肺部感染病原菌分布及危险因素分析  

Distribution of Pathogenic Bacteria and Risk Factors of Pulmonary Infection in Children after Abdominal Surgery

作　　者：杨倩[1] 刘捷[1] 

机构地区：[1]四川大学华西医院小儿外科,四川成都610041

出　　处：《河北医学》2018年第2期192-196,共5页Hebei Medicine

基　　金：四川省科技厅科技支撑计划;(编号:2015SZ0089)

摘　　要：目的:分析腹部外科术后患儿肺部感染病原菌分布及危险因素。方法:回顾性分析我院2013年4月至2017年4月835例腹部外科手术患儿的临床资料,鉴定91例肺部感染患儿的病原菌,统计其病原菌分布,分析患儿术后肺部感染的危险因素。结果:91例术后肺部感染患儿中,混合感染47例(51.65%),单纯感染44例(48.35%),共获得230份标本,检出88株病原菌株;革兰阴性菌49株(55.68%),革兰阳性菌31株(35.23%),真菌8株(9.09%),溶血不动杆菌、肺炎克雷伯菌、溶血葡萄球菌、金黄色葡萄球菌为主要病原菌,分别占18.18%、14.77%、14.77%、11.36%;手术方法、手术部位、是否合并先天性心脏病、术前白蛋白水平、术前是否使用抗生素、术后机械通气时间、侵入性操作、慢性呼吸系统疾病是影响腹外科患儿术后肺部感染的危险单因素(P<0.05);术前白蛋白水平、术后机械通气时间、侵入性操作、慢性呼吸系统疾病是影响腹部外科患儿术后肺部感染的独立危险因素(P<0.05)。结论:革兰阴性菌是腹外科患儿术后肺部感染的主要病原菌,肺部感染与患儿术前白蛋白水平、术后机械通气时间、侵入性操作、慢性呼吸系统疾病等因素有关,临床中应针对各项危险因素采取有效的预防措施。Objective： To analyze the pathogenic bacteria distribution and risk factors of postoperative pulmonary infection in children with abdominal surgery. Methods： The clinical data of 835 cases of children with abdominal surgery in our hospital from April 2013 to April 2017 were retrospectively analyzed. The pathogenic bacteria in 91 cases of children with pulmonary infection were identified,and the pathogenic bacteria distribution was recorded,and the risk factors for children with postoperative pulmonary infection were analyzed. Results： Among 91 cases of children with postoperative pulmonary infection,there were 47 cases（51.65%） with mixed infection and 44 cases（48. 35%） with pure infection,and 230 specimens were obtained and 88 pathogenic bacteria strains were detected. There were 49 strains（55.68%） of gram-negative bacteria,31 strains（35.23%） of gram-positive bacteria and 8 strains（9.09%） of fungi,and the acinetobacterhaemolyticus,klebsiellapneumoniae,staphylococcus haemolyticus and staphylococcus aureus were the main pathogenic bacteriaan. They accounted for 18.18%,14.77%,14.77% and 11.36% respectively. Surgical methods,surgical site,congenital heart disease,albumin level before surgery,whether to use antibiotics before surgery,postoperative mechanical ventilation time,invasive operation,chronic respiratory diseases were the risk single factors affecting the postoperative pulmonary infection in children with abdominal surgery（P 〈0.05）. The albumin before surgery,postoperative mechanical ventilation time,invasive operation and chronic respiratory diseases were independent risk factors for postoperative pulmonary infection in children with abdominal surgery（P 〈0.05）. Conclusion： Gram-negative bacteria are the main pathogenic bacteria of postoperative pulmonary infection in children with abdominal surgery,and the pulmonary infection is related to the preoperative albumin level before surgery,postoperative mechanical ventilation time,invasive operative,chronic respiratory dise

关 键 词：腹外科 患儿 肺部感染 病原菌 危险因素 

分 类 号：R726.5[医药卫生—儿科]