全麻手术患者围术期感染与麻醉相关因素的回归分析与预防措施

Regression analysis of anesthetic factors related to perioperative infections in surgery patients with general anesthesia and preventive measures

目的分析2010年度手术患者围术期感染的相关麻醉危险因素,为临床预防和控制围术期感染提供依据。方法前瞻性观察2010年1-12月2000例患者的围术期感染并对麻醉相关危险因素进行非条件logistic回归分析。结果单因素分析结果显示,两组病例在气管导管(OR=1.027,P=0.032)、喉镜镜片(OR=1.407,P=0.046)、全麻通气道(OR=1.342,P=0.019)、过滤器(OR=1.603,P=0.011)以及钠石灰(OR=2.528,P=0.023)等方面的差异有统计学意义;进一步的多因素logisitic回归分析发现,气管导管(OR=1.046,P=0.039)、喉镜镜片(OR=1.218,P=0.042)、全麻通气道(OR=1.372,P=0.031)、过滤器(OR=1.805,P=0.023)以及钠石灰(OR=2.319,P=0.026)是围术期感染的麻醉相关独立危险因素。结论全麻手术患者围术期感染与气管插管、麻醉器械清洁度、麻醉管理等有关,预防的关键在于提高麻醉医务人员的无菌观念。

OBJECTIVE To study the anesthetic factors related to perioperative infections in surgery patients with general anesthesia in 2010 so as to provide basis for the clinical prevention and control of perioperative infections.METHODS The perioperative infections in 2000 patients from Jan.2010 to Dec.2010 were prospectively observed,and the non-conditional logistic regression analysis was performed for anesthesia-related risk factors.RESULTS The univariate regression analysis showed that there were statistically significant differences in the endotracheal tube（OR=1.027,P=0.032）,laryngoscope lens（OR=1.407,P=0.046）,general anesthesia airway（OR=1.342,P=0.019）,filters（OR=1.603,P=0.011）,and sodium lime（OR=2.528,P=0.023） between the two groups.Multivariate logisitic regression analysis showed that the endotracheal tube（OR=1.046,P=0.039）,laryngoscope lens（OR=1.218,P=0.042）,general anesthesia airway（OR=1.372,P=0.031）,filters（OR=1.805,P=0.023）,and sodium lime（OR=2.319,P=0.026） were the independent risk factors of perioperative anesthesia-related infections.CONCLUSION The incidence of the perioperative infections in the patients with general anesthesia is related to the endotracheal intubation,cleanliness of anesthesia equipment,and anesthesia management,and the key to prevent the perioperative infections with is to improve anesthesiologists′ sterile concept.