气管切开术后下呼吸道细菌定植菌分析及对患者预后、转归的影响  

An Analysis of Bacterial Colonization in Lower Respiratory Tract after Tracheotomy and Its Influence on Prognosis of Patients

作　　者：赖宇尧 刘煊玮 聂勇波[3] 王志明 李桂珊 LAI Yuyao;LIU Xuanwei;NIE Yongbo;WAN Zhiming;LI Guishan(Clinical Laboratory, Nan′ao People′s Hospital of Dapeng New Distrisct ,Shenzhen 518121,China;Rehabilitation Department, Nan′ao People′s Hospital of Dapeng New Distrisct ,Shenzhen 518121,China;Clinical Laboratory, Shenzhen Second People′s Hospital, Shenzhen 518037,China)

机构地区：[1]深圳市大鹏新区南澳人民医院检验科,广东深圳518121 [2]深圳市大鹏新区南澳人民医院康复科,广东深圳5181213 [3]深圳市第二人民医院检验科,广东深圳518037

出　　处：《标记免疫分析与临床》2021年第6期973-976,1001,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探究并分析气管切开术后下呼吸道细菌定植菌分析及对患者预后、转归的影响。方法选取我院2019年1月至2021年1月本院收治的合并下呼吸道细菌定植的气管切开患者44例,作为对照组。另选取同期本院收治的未合并下呼吸道细菌定植的气管切开患者46例,作为观察组。分析气切患者上呼吸道定植菌类型,并观察并比较两组患者一般资料(包括性别、年龄、体重、气切病因等),气切前后FEV1、FEV1/FVC、治疗结局、生活质量评分。结果气管切开患者病原菌定植以革兰阴性菌为主,约占76.76%,其中铜绿假单胞菌比例最高,约占30.27%,革兰阳性菌定植少于革兰阴性菌,约占16.22%,其中金黄色葡萄球菌比例最高,约占9.73%;两组患者气切前FEV1、FEV1/FVC差异无统计学意义(P>0.05),气切后3个月观察组患者FEV1、FEV1/FVC均较气切前显著改善(P<0.05),气切后3个月观察组患者FEV1和FEV1/FVC明显高于对照组(P<0.05);观察组患者30 d死亡率、平均气道护理干预、平均干预时间、面部皮损、ICU住院时间、总住院时间均显著低于对照组(P<0.05);经重复方差分析,两组患者气切前后生活质量评分比较差异具有统计学意义(P<0.05),两组患者术前生活质量评分差异无统计学意义(P>0.05),气切后,两组患者生活质量评分均较气切前明显改善(P<0.05),气切后1个月、气切后3个月观察组患者生活质量评分明显高于对照组(P<0.05),差异具有统计学意义。结论未合并下呼吸道细菌定植的气切患者较合并下呼吸道细菌定植的气切患者具有更好的预后及转归,对于气切患者而言,下呼吸道细菌定植情况值得临床密切关注。Objective To analyze the bacterial colonization of lower respiratory tract after tracheotomy and its influence on the prognosis of patients.Methods 44 cases of tracheotomy patients with lower respiratory tract bacterial colonization in our hospital from January,2019 to January,2021 were selected as the control group.Another 46 cases of tracheotomy patients without lower respiratory tract bacterial colonization in our hospital during the same period were selected as the observation group.The types of colonization bacteria in upper respiratory tract of patients with tracheotomy were analyzed,and the general information(including gender,age,weight,etiology of tracheotomy,etc.),FEV1,FEV1/FVC,treatment outcome and quality of life scores of the two groups were also observed and compared.Results The results showed as following:Gram-negative bacteria accounted for 76.76%,Pseudomonas aeruginosa accounted for 30.27%,gram positive bacteria less than Gram-negative bacteria accounted for 16.22%,and Staphylococcus aureus accounted for 9.73%.FEV1 and FEV1/FVC had no significant difference between the two groups before tracheotomy(P>0.05),but FEV1/FVC of the observation group 3 months after tracheotomy were significantly higher than those of the control group 3 months after tracheotomy(P<0.05).The 30-day mortality rate,average airway nursing intervention,average intervention time,facial skin lesions,ICU length of stay and total length of stay of the observation group were significantly lower than those of the control group(P<0.05).By repeated analysis of variance,for the patients in the two groups underwent tracheotomy,there was a significant difference in the scores of quality of life before and after tracheotomy(P<0.05),and there was no significant difference in the scores of quality of life before operation between the two groups(P>0.05).After tracheotomy,the scores of quality of life in the two groups were significantly improved compared with those before tracheotomy(P<0.05),and the scores of quality of life in the observati

关 键 词：细菌定植 气管切开 预后 生活质量 死亡率 

分 类 号：R372[医药卫生—病原生物学]