老年腹部手术患者肺部感染的风险因素分析及护理  

Analysis and Nursing of Risk Factors of Lung Infection in Elderly Patients Undergoing Abdominal Surgery

作　　者：郭瑶 GUO Yao(Hospital-Acquired Infection Control Department,Sichuan Provincial Judicial Police General Hospital,Chengdu,Sichuan Province,610225 China)

机构地区：[1]四川省司法警官总医院院感科,四川成都610225

出　　处：《中外医疗》2021年第10期132-134,138,共4页China & Foreign Medical Treatment

摘　　要：目的分析老年腹部手术患者肺部感染的风险因素,总结护理措施。方法回顾性分析2019年3月—2020年2月于该院行腹部手术的180例老年患者资料。观察并记录180例老年腹部手术患者的基本情况与手术情况。针对老年腹部手术患者肺部感染的风险因素进行单因素分析与多因素Logistic回归分析。结果经单因素分析显示,有吸烟史、术前肺功能异常、合并症≥2种、美国麻醉师协会(ASA)分级Ⅲ~Ⅳ级、上腹部手术、手术时间≥3 h、术中失血量≥200 mL、术后肌注镇痛的发生率73.68%、60.53%、63.16%、47.37%、86.84%、73.68%、73.68%、84.21%均高于未感染组42.25%、14.08%、36.62%、28.17%、67.61%、47.18%、50.70%、64.79%,差异有统计学意义(χ^(2)=11.852、35.561、8.655、5.060、5.463、8.448、6.411、5.276,P<0.05)。经多因素Logistic回归分析显示,吸烟史、合并症、ASA分级、手术部位、手术时间、术中失血量、术后镇痛均为老年腹部手术患者肺部感染的独立风险因素(P<0.01)。结论吸烟史、术前肺功能异常、合并症、ASA分级、手术部位、手术时间、术中失血量、术后镇痛是影响老年腹部手术患者肺部感染的风险因素,临床应采取有效的护理措施,预防此类问题,保障患者的就医质量。Objective To analyze the risk factors of lung infection in elderly patients undergoing abdominal surgery,and to summarize nursing measures.Methods The data of 180 elderly patients who underwent abdominal surgery in the hospital from March 2019 to February 2020 were retrospectively analyzed.Observed and record the basic and surgical conditions of 180 elderly patients undergoing abdominal surgery.Single factor analysis and multivariate Logistic regression analysis were carried out for the risk factors of lung infection in elderly abdominal surgery patients.Results Univariate analysis showed that there was a history of smoking,preoperative lung function abnormality,comorbidities≥2,American Association of Anesthesiologists(ASA)gradeⅢ-Ⅳ,upper abdominal surgery,operation time≥3 h,intraoperative blood loss≥200 mL,the incidence of postoperative intramuscular analgesia of 73.68%,60.53%,63.16%,47.37%,86.84%,73.68%,73.68%,84.21%were higher than those of the uninfected group 42.25%,14.08%,36.62%,28.17%,67.61%,47.18%,50.70%,64.79%,the difference was statistically significant(χ^(2)=11.852,35.561,8.655,5.060,5.463,8.448,6.411,5.276,P<0.05).Multivariate Logistic regression analysis showed that smoking history,comorbidities,ASA classification,surgical site,operation time,intraoperative blood loss,and postoperative analgesia were all independent risk factors for lung infection in elderly patients undergoing abdominal surgery(P<0.01).Conclusion Smoking history,preoperative pulmonary function abnormalities,comorbidities,ASA classification,surgical site,operation time,intraoperative blood loss,and postoperative analgesia are risk factors affecting lung infection in elderly patients undergoing abdominal surgery.Effective clinical care measures should be taken to prevent such problems and ensure the quality of patients’medical treatment.

关 键 词：老年 腹部手术 肺部感染 风险因素 护理 

分 类 号：R473.6[医药卫生—护理学]