心脏手术后患者院内获得性肺炎的危险因素

The risk factors of nosocomial pneumonia for patients following cardiac surgery

心脏手术是心血管疾病的主要干预手段之一,其术后感染并发症最常见为院内获得性肺炎。本文综述了近年来国内外多篇关于心脏手术患者发生院内获得性肺炎的危险因素的研究报道。主要的危险因素包括:气管插管、机械通气辅助呼吸、仰卧体位、抑酸药物滥用、停留鼻胃管、吞咽功能障碍或神经功能障碍、镇痛药物使用、输血、手术时间或体外循环时间较长、急诊手术、高血压、术后心房颤动、ICU停留时间延长、低白蛋白血症、C反应蛋白升高、术前广谱抗生素的使用、高龄、慢性心功能不全、糖尿病、肝硬化及慢性肾衰竭等。

Nosocomial pneumonia is the most common complication of cardiac surgery which is one of the effective treatments for heart disease. According to the lasted literature, the risk factors of nosocomial pneumonia for patients following cardiac surgery including intubation, mechanical ventilation, supine body position, antiacid abuse, nasogastric tube, swallowing dysfunction or neurologic dysfunction, morphine, transfusion, longer surgery time or cardiopuimonary bypass time, emergency surgery, arterial hypertension, atrial fibrillation, longer stay in the ICU, hypoalbuminemia, higher C-reactive protein level, previous broad spectrum antibiotics, octogenarians, chronic heart dysfunction, diabetes mellitus, liver cirrhosis and chronic renal failure.