持续胃肠减压患者呼吸道感染因素分析及预防对策

Factor analysis and preventive measures for respiratory tract infections in patients undergoing continuous gastrointestinal decompression

目的探讨持续胃肠减压患者发生呼吸道感染的原因,并提出相应的预防对策,为临床防治措施的实施提供参考。方法选取2010年1月-2012年12月医院外科收治需要进行持续胃肠减压的患者200例,将2010年1月-2011年1月入院的85例患者为对照组,2011年1月-2012年12月入院的115例患者为观察组;对照组给予常规的处理措施干预,观察组接受规范化处理;对比两组患者置管操作因素和呼吸道感染的发生率,采用SPSS 17.0进行统计分析。结果观察组中仅有1例多次置管,置管操作失误率为0.87%;对照组中1例胃管误入气管、3例多次置管、1例胃管留置时间过长、2例拔管方法错误,操作失误率为8.24%,观察组操作失误率显著低于对照组;患者呼吸道感染的发生率观察组为3.48%、对照组为12.94%,两组比较,差异均有统计学意义(P<0.05)。结论持续胃肠减压的操作质量和呼吸道感染的发生率密切相关,操作上应掌握正确的置管、拔管技术,减少插管次数和留置胃管时间,提高患者的配合度以减少并发呼吸道感染。

OBJECTIVE To investigate the causes and preventive measures for respiratory tract infections in patients undergoing continuous gastrointestinal decompression,and to provide reference for the clinical prevention and control measures.METHODS Totally 200 patients who needed continuous gastrointestinal decompression in our hospital during Jan.2010 to Dec.2012 were selected.According to the admission time,85 patients hospitalized during Jan.2010 to Jan.2011 were set as the control group,while the other 115 patients hospitalized during Jan.2011 to Dec.2012 were set as the observation group.The control group was given with routine intervention.The observation group received standardized intervention.The manipulation error events and the incidence of respiratory tract infection of both groups were compared.Data were analyzed with SPSS 17.0.RESULTS The manipulation error event rate was 0.87% in the observation group which had one case of multiple catheterization,significantly lower than 8.24% in the control group which had one case of mistaken insert of stomach tube into trachea,three cases of multiple catheterization,one case of prolonged catheter retention and two cases of wrong extubation.The respiratory tract infection rate was 3.48% in the observation group,while it was 12.94% in the control group,which showed significant difference（P0.05）.CONCLUSION The quality of manipulation of continuous gastrointestinal decompression and the incidence of respiratory tract infection is closely related.For the manipulation operation clinicians should grasp the catheterization and extubation technique correctly,reduce the times of intubation and gastric tube detaining time,and improve patient compliance in order to reduce the complication with respiratory tract infections.