全身麻醉子宫切除术后肺部感染影响因素  

Analysis of related factors of pulmonary infection in hysterectomy patients after general anesthesia

作　　者：刘涌[1] 叶玉萍[1] 王正坤[1] 时文俊[1] 任慧娟 王阿琳[1] 邓运香 胡路琴[2] LIU Yong;YE Yu-ping;WANG Zheng-kun;SHI Wen-jun;REN Hui-juan;WANG A-lin;DENG Yun-xiang;HU Lu-qin(Maternal and Child Health Hospital of Foshan,Foshan,Guangdong 528000,China)

机构地区：[1]广东省佛山市妇幼保健院麻醉科,广东佛山528000 [2]广东省佛山市妇幼保健院妇科,广东佛山528000

出　　处：《中华医院感染学杂志》2020年第24期3779-3782,共4页Chinese Journal of Nosocomiology

基　　金：佛山市自筹经费类科技计划基金资助项目(2015AB00407)。

摘　　要：目的探讨全身麻醉子宫切除术后患者肺部感染的影响因素。方法选取2017年1月-2018年12月广东省佛山市妇幼保健院收治的全身麻醉下行子宫切除术的180例子宫肌瘤患者为研究对象,根据术后是否发生肺部感染分为感染组30例与未感染组150例,调查感染患者病原菌情况,分析患者年龄、基础疾病、生化指标等临床资料,归纳全身麻醉子宫切除术后患者肺部感染的影响因素。结果术后肺部感染共30例(16.67%),共检出45株病原菌,其中革兰阴性菌26株,革兰阳性菌18株,真菌1株,以铜绿假单胞菌、金黄色葡萄球菌、大肠埃希菌为主。多因素分析结果显示,高龄、合并糖尿病、术前化疗、腹腔感染、手术时间过长、血红蛋白过低、术后卧床时间长、切口疼痛程度高以及术后抗菌药物使用时间短均为全身麻醉子宫切除患者术后发生肺部感染的独立高危因素(P<0.05)。结论全身麻醉子宫切除术后患者肺部感染率较高,临床中对于高危患者应加强监测,及时采取有效措施降低肺部感染率。OBJECTIVE To explore the related factors of lung infection in patients after hysterectomy under general anesthesia.METHODS From Jan 2017 to Dec 2018,180 patients with uterine fibroids undergoing hysterectomy under general anesthesia who were admitted to the Foshan Maternal and Child Health Hospital of Guangdong Province from January 2017 to December 2018 were recruited as the research subjects.According to whether there was lung infection after the operation,they were divided into the infection group with 30 cases and the uninfected group with 150 cases.The pathogenic bacteria in the infected patients were investigated,the clinical data of the patients’age,underlying diseases,biochemical indicators,etc.were analyzed,and the influencing factors of lung infection in patients after general anesthesia hysterectomy were summarized.RESULTS A total of 30 cases(16.67%)of postoperative lung infections were detected,in which 45 pathogens were detected,including 26 gram-negative bacteria,18 gram-positive bacteria and 1 fungus,and the main bacteria were Pseudomonas aeruginosa and Staphylococcus aureus and Escherichia coli.Further multivariate analysis showed that advanced age,diabetes mellitus,preoperative chemotherapy,abdominal infection,long operation time,low hemoglobin,long postoperative bed time,high incision pain and short postoperative antibiotic use time were all general anesthesia independent high-risk factors of pulmonary infection after hysterectomy(P<0.05).CONCLUSION After general anesthesia and hysterectomy,the lung infection rate in patients is relatively high.In clinical practice,high-risk patients should be monitored and effective measured to aviod the lung infection in time.

关 键 词：全身麻醉 子宫切除术 术后 肺部感染 危险因素 

分 类 号：R619.3[医药卫生—外科学]