气管切开术后下呼吸道病原菌感染分析及预防措施

Pathogens causing lower respiratory tract infections after tracheotomy and prevention countermeasures

目的探讨气管切开术后下呼吸道病原菌感染的相关原因及防治措施,以减少气管切开术后的并发症发生。方法回顾性分析2007-2012年医院气管切开术后下呼吸道感染、病原菌分布及感染原因。结果 134例气管切开的患者下呼吸道感染72例,感染率为53.7%,气管切开术后1、5、10d下呼吸道感染的分别占4.17%、52.78%和43.05%,差异有统计学意义(P<0.05);病原菌主要为革兰阴性菌为主,占77.45%,下呼吸道感染主要与环境、医疗器械及抗菌药物使用不当等有关。结论应早期加强对患者、环境及器械的消毒工作,合理使用抗菌药物,以减轻气管切开术后的并发症。

OBJECTIVE To investigate related factors for lower respiratory tract infections caused by the pathogens after tracheotomy and to propose prevention countermeasures so as to reduce the incidence of the complications after the tracheotomy.METHODS The lower respiratory tract infections,distribution of the pathogens,and the causes of infections were retrospectively analyzed after undergoing the tracheotomy from 2007 to 2012.RESULTS Of 134 patients undergoing the tracheotomy,the incidence rate of lower respiratory tract infections was 53.7%,the incidence rates increased by 4.17%,52.78%,and 43.05% on the 1st,5th,and 10th day after the tracheotomy,respectively,the difference was statistically significant（P0.05）.The gram-negative bacteria were the predominant pathogens,accounting for 77.45%,the lower respiratory tract infection was related to the environment and the irrational use of medical devices and antibiotics.CONCLUSION It is necessary to strengthen the disinfection of the patients,environment,and medical devices and reasonably use antibiotics so as to reduce the incidence of the complications after the tracheotomy.