全麻气管插管并发下呼吸道感染因素分析

Analysis of factors of general anesthesia by tracheal intubation complicated with lower respiratory tract infection

目的分析全麻气管插管并发下呼吸道感染的因素。方法对2007年1月-2011年2月行全麻下气管插管发生下呼吸道感染的128例患者,临床资料进行回顾性分析,评估其引发感染的各项因素。结果各种因素与感染率分析,年龄≥60岁占6.24%、<60岁占3.23%;麻醉时间≥3h占10.14%、<3h占2.06%;拔管延迟≥2h占11.15%、<2h占3.28%;术后镇痛者占6.98%、未镇痛者占2.39%;插管过深者占10.06%、插管正常者占3.33%,插管不熟练占9.26%、熟练占3.41%;拔管指征不完全占11.74%、拔管指征完全占3.29%,感染部位以胸部手术者最高为33.59%,其次为腹部手术占31.25%等,经比较差异均有统计学意义(均P<0.05)。结论全麻气管插管并发下呼吸道感染因素较多,部位以胸部手术为主,应引起重视。

OBJECTIVE To analyze the factors of general anesthesia by tracheal intubation complicated with lower respiratory tract infection.METHODS The clinical data of 128 patients with lower respiratory tract infection tracheal intubation in our hospital from Jan 2007 to Feb 2011 were retrospectively analyzed,and the various factors according infection were evaluated.RESULTS The infection rate of patients over 60 years old（6.24%）was higher than that of uder 60 years old（3.23%）,infection rate of duration of anesthesia≥3h（10.14%） was higher than that of 3h（2.06%）,extubation delay≥2h（11.15%）was higher than that of 2h（3.28%）,infection rate with analgesia（6.98%） was higher than that without analgesia（2.39%）,intubation inserted too deep（10.06%）was higher than that of normol intubation（3.33%）,intubation inexperience（9.26%）was higher than that of normol intubation proficiency（3.41%）,extubation indication imperfection（11.74%） was higher than that perfect indication（3.29%）,the highest infection site rate was thoracic surgery（33.59%）,the abdominal surgery（31.25%） was second,all P〈0.05,there were significant differences.CONCLUSION There are many factors of general anesthesia by tracheal intubation complicated with lower respiratory tract infection,the main infection site is thoracic,and it should be paid attention to.