左向右分流型先天性心脏病医院内下呼吸道感染临床分析

Lower Respiratory Tract Infection among Inpatients with Congenital Heart Disease

目的了解左向右分流型先天性心脏病围手术期医院内下呼吸道感染情况,为临床防治提供依据。方法对2003年1月-2005年12月收治的2564例左向右分流型先天性心脏病围手术期医院内下呼吸道感染情况进行回顾性分析。结果2564例患者中下呼吸道感染发病率为11.27%,年龄<2岁者下呼吸道感染发病率达15.51%;最常见的病原菌为铜绿假单胞菌,占18.60%;继发下呼吸道感染者死亡率高于无感染者。结论心脏病所致肺血增多、年龄<2岁、使用机械通气和抗菌药物应用不当是造成医院内下呼吸道感染的主要因素,继发下呼吸道感染增加患者死亡率。

OBJECTIVE To find out the situation of peri-operational lower respiratory tract infection in inpatients with congenital heart disease of left to right shunt and provide evidence for clinical prevention and treatment. METHODS Peri-operational lower respiratory tract nosocomial infection in 2 564 cases of congenital heart disease with left to right shunt during Jan 2003 to Dec 2005 was analyzed retrospectively. RESULTS The incidence rate of lower respiratory tract infection was 11.27% among 2 564 cases. The incidence rate was 15.51% in patients less than 2 years old. The most common pathogen was Pseudomonas aeruginosa （18.60%）. The death rate in cases with lower respiratory tract nosocomial infection was higher than these non-infection cases. CONCLUSIONS Pulmonary congestion, less than 2 years old, mechanical ventilation and antibiotics abuse are main causes of lower respiratory tract nosocomial infection in patients with congenital heart disease with left to right shunt. Nosocomial infection can increase death rate.