某综合医院麻醉手术患者术后呼吸道感染现状及其影响因素  

Influencing factors of postoperative respiratory tract infection in patients undergoing anesthesia surgery in a general hospital

作　　者：宿文清[1] 韩燕敏[1] SU Wen-qing;HAN Yan-min(First Medical Center,PLA General Hospital,Beijing 100039,China)

机构地区：[1]解放军总医院第一医学中心麻醉科,北京100039

出　　处：《中华医院感染学杂志》2022年第20期3114-3117,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨解放军总医院第一医学中心麻醉手术患者呼吸道感染现状及影响因素。方法回顾性分析2020年3月-2022年2月解放军总医院第一医学中心4382例手术麻醉患者的临床资料,统计术后呼吸道感染发生情况,并采用单因素及多因素Logistic回归分析麻醉手术患者呼吸道感染的影响因素。结果4382例麻醉手术患者中,术后呼吸道感染患者共399例,感染率为9.11%,其中神经中枢系统、胸外科疾病及肝胆、消化系统疾病患者感染率较高,分别为3.95%(173/4382)、1.96%(86/4382)、1.23%(54/4382);共检出病原菌399株,其中革兰阴性菌144株占36.09%,革兰阳性菌139株占34.84%,真菌116株占29.07%,以金黄色葡萄球菌、铜绿假单胞菌及白假丝酵母为主;年龄(OR=3.165)、合并基础疾病(OR=4.558)、全身麻醉(OR=2.005)、麻醉时间(OR=2.417)、使用抗菌药物(OR=6.603)及急诊手术(OR=4.106)是麻醉手术患者术后呼吸道感染的影响因素(P<0.05)。结论中枢神经系统疾病患者术后更易出现呼吸道感染,其次为胸外科疾病及肝胆、消化系统疾病患者;需警惕真菌类感染;而导致麻醉手术患者术后感染的影响因素为年龄、合并基础疾病、全身麻醉、麻醉时间、使用抗菌药物及急诊手术。OBJECTIVE To investigate the current situation and influencing factors of respiratory tract infection in patients undergoing anesthesia surgery in the First Medical Center of Chinese PLA General Hospital.METHODS The clinical data of 4382 patients with surgical anesthesia in the First Medical Center of Chinese PLA General Hospital from Mar.2020 to Feb.2022 were retrospectively analyzed,the incidence of postoperative respiratory tract infection was counted,and the influencing factors of respiratory tract infection in patients undergoing anesthesia surgery were analyzed by univariate and multivariate logistic regression.RESULTS Among the 4382 patients undergoing anesthesia surgery,there were 399 patients with postoperative respiratory tract infection,and the infection rate was 9.11%.Of which,the infection rates of patients with diseases of the nervous central system,thoracic surgery,and hepatobiliary and digestive system diseases were higher,which were 3.95%(173/4382),1.96%(86/4382)and 1.23%(54/4382)respectively.A total of 399 strains of pathogenic bacteria were detected,of which 144 strains of Gram-negative bacteria accounted for 36.09%,139 strains of Gram-positive bacteria accounted for 34.84%,and 116 strains of fungi accounted for 29.07%,mainly Staphylococcus aureus,Pseudomonas aeruginosa and Candida.Age(OR=3.165),combined with basic diseases(OR=4.558),general anesthesia(OR=2.005),duration of anesthesia(OR=2.417),use of antibiotics(OR=6.603)and emergency surgery(OR=4.106)were the influencing factors of postoperative respiratory tract infection in patients undergoing anesthesia surgery(P<0.05).CONCLUSION Patients with central nervous system diseases were more prone to respiratory tract infection,followed by patients with thoracic surgery diseases,hepatobiliary and digestive system diseases.It was necessary to be vigilant against fungal infection.The independent risk factors of postoperative infection in patients undergoing anesthesia were increased age,combined with basic diseases,local infiltration anesthesia,ane

关 键 词：手术 麻醉 呼吸道感染 病原菌 影响因素 

分 类 号：R619[医药卫生—外科学]