心血管外科术后呼吸道感染病原菌分布和影响因素分析及相应护理措施研究  

Analysis of Distribution and Influencing Factors of Pathogens of Respiratory Tract Infection after Cardiovascular Surgery and Study on Corresponding Nursing Measures

作　　者：金珊珊 Jin Shanshan(Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院,北京市100050

出　　处：《中国病案》2021年第12期113-116,共4页Chinese Medical Record

摘　　要：目的探讨影响某院心血管外科术后感染因素和相应护理措施,为今后心外科术后感染和预防措施制定提供依据。方法选取2016年5月1日-2019年12月31日某院收治的心外科术后感染患者134例作为研究组,随机选取同期未合并感染的心外科手术患者134例作为对照组,分析心外科术后感染病原菌分布情况,对心外科术后感染患者临床资料进行单因素分析,对心外科术后可能导致感染影响因素进行多因素Logistic回归分析,对相应护理措施进行研究,对护理措施实施前后患者生活质量评分进行比较。结果134例心外科术后患者检出145个致病菌,革兰阴性菌和革兰阳性菌分别占69.66%和21.38%;以大肠埃希菌和金黄色葡萄球菌最为常见,占比分布为31.72%和8.97%;白色假丝酵母菌,占8.97%。经χ^(2)检验,年龄、气管插管时间、体外循环、合并基础疾病、引流留置时间、预防性使用抗菌药物等因素为心脏外科术后感染的影响因素,差异有统计学意义,P<0.05。年龄≥50岁、气管插管时间≥5天、体外循环、合并基础疾病、引流留置时间≥5天、预防性使用抗菌药物等因素均为可能导致心外科术后发生感染的独立危险因素,差异有统计学意义,P<0.05。护理干预后,心外科术后感染患者在躯体功能、总体健康等方面生活质量评分明显高于干预前,差异有统计学意义,P<0.05。结论心外科术后感染与多种因素存在密切关联,其病原菌以大肠埃希菌为主的革兰阴性菌最为常见,应根据患者个性化特点,采取适当的护理措施进行干预,降低心脏外科术后感染风险。Objective To discuss the influence factors of infection after cardiac surgery in a hospital and to provide basis for the formulation of infection and preventive measures after cardiac surgery in the future.Methods Selection in May 1,2016 to December 31,2019 postoperative infection in patients with cardiovascular surgery of a hospital 134 cases as infection group,and at the same time without co-infection line of 134 patients with cardiovascular surgery as uninfected group,analysis of cardiovascular surgery postoperative infection of pathogenic bacteria distribution of cardiovascular surgery clinical data of postoperative infection in patients with single factor analysis,and factor of influence on cardiovascular surgery could lead to infection multiariable Logistic regression analysis,and the corresponding nursing measures were studied.Results A total of 145 pathogenic bacteria were detected in 134 patients after cardiovascular surgery,and gram-negative bacteria and gram-positive bacteria accounted for 69.66% and 21.38% respectively.Escherichia coli and Staphylococcus aureus were the most common bacteria,accounting for 31.72% and 8.97% respectively.Candida albicans accounted for 8.97%.After χ^(2) test,age,duration of endotracheal intubation,extracorporeal circulation,combined with underlying diseases,duration of indwelling drainage,prophylactic use of antibiotics and other factors were the influential factors of postoperative infection after cardiovascular surgery,and the differences were statistically significant(P<0.05).Age≥50 years old,duration of endotracheal intubation≥5 d,extracorporeal circulation,combined with underlying diseases,duration of indwelling drainage≥5 d,preventive use of antibiotics and other factors were all independent risk factors for postoperative infection after cardiovascular surgery,and the differences were statistically significant(P<0.05).After the intervention,the quality of life scores of patients with infection after cardiac surgery were significantly higher than those before

关 键 词：心血管外科 呼吸道感染 病原菌分布 护理措施 

分 类 号：R446.5[医药卫生—诊断学] R473.6[医药卫生—临床医学]