老年胆道术后医院感染临床及病原学分析

Etiology of nosocomial infection in senile patients after biliary tract surgery

目的探讨老年胆道疾病患者术后继发医院感染的临床及病原学特点及预防措施。方法回顾性调查分析267例老年胆道手术患者术后继发医院感染的临床资料。结果老年胆道术后继发医院感染发生率为12.36%;最常见的感染部位依次为呼吸道、血液、泌尿道,分别占30.30%、21.21%、18.18%;病原菌分布上依次为革兰阴性杆菌、革兰阳性球菌、真菌,分别占47.37%、27.63%、25.00%;老年胆道术后患者生理特点是继发医院感染的重要原因,高龄、急诊手术、合并症是引起医院感染的危险因素。结论加强对呼吸道、血液系统和泌尿系统的重点监测,重视围手术期处理,积极有效地治疗原发病,合理应用抗菌药物是预防医院感染的有效措施。

OBJECTIVE To investigate the risk factors and the precaution of nosocomial infections in old patients with tract surgery.METHODS A total of 267 elderly patients with biliary operations were retrospectively reviewed.RESULTS The incidence rate of secondary nosocomial infection in elderly patients was 12.36%.The main sites of infection were respiratory tract,hematological system and urinary tract accounting for 30.30%,21.21% and 18.18%.The main pathogenic bacteria were Gram-negative bacillus,fungi and Gram-positive coccus accounting for 47.37%,27.63% and 25.00% respettively.The physiological characteristics of the elderly patients after biliary tract operations were the important causes for the secondary infection.The age,emergency operations and complications were the risk factors for postoperative nosocomial infections.CONCLUSION The effective meassures to prevent nosocomial infection are enforcing the preoperative and postoperative treatment,treating the primary affection actively and effectively,enhancing monitoring to respiratory tract,hematological system and urinary system and using antibiotics rationally.