胸部微创手术患者肺部感染的预防与控制

The prevention and control of lung infections after minimally invasive operation

目的：研究胸部微创手术患者肺部感染的情况，并总结预防感染的措施，以降低术后肺部感染的发生率。方法选取2010年3月－2014年3月医院收治的胸部微创手术患者500例，分析术后发生感染患者的年龄、性别、吸烟史、慢性病、术中出血量、术前肺功能检查、手术时间以及术后住院时间，并研究其与肺部感染的关系，采用SPSS 17．0软件进行统计分析。结果500例进行胸部微创手术的患者中有89例发生肺部感染，感染率为17．8％；年龄＞60岁、有慢性疾病及有吸烟史是患者肺部发生感染的相关因素（ P＜0．05）；胸部微创手术患者的手术时间、术前肺功能检查气道阻塞肺活量的测定（FEV1／FVC ）及术中出血量者比较差异有统计学意义（P＜0．05）；所有患者均治愈出院，其中住院时间为10～24 d ，平均为（15．6＆#177;2．3）d。结论年龄＞60岁、有慢性疾病及有吸烟史是肺部发生感染的相关因素，应根据患者的情况进行有效干预可以降低肺部感染的发生率。

OBJECTIVE To study the pulmonary infections after minimally invasive chest operation ,and to summa‐rize the measures to prevent infections ,so as to reduce the incidence rate of postoperative pulmonary infections . METHODS A total of 500 cases of patients using minimally invasive thoracic operation from Mar .2013 to Mar . 2014 in our hospital were selected .The patient′s age ,genders ,history of smoking ,chronic disease ,the amount of intraoperative bleeding ,preoperative pulmonary function test ,operation time and postoperative hospital stay were analyzed and observed to find their relationships with lung infections .All data were analyzed by SPSS 17 .0 software .RESULTS Totally 89 patients of 500 cases occurred the pulmonary infections after minimally invasive operation and the infection rate was 17 .8% .There was a correlation between age 〉60 years ,chronic disease ,his‐tory of smoking and lung infection （P〈0 .05） .The operation time ,determination of airway obstruction lung vol‐ume in pulmonary function test （FEV1/FVC） and intraoperative blood loss has statistically difference （P〈0 .05） in patients with minimally invasive operation .All patients were cured ,and the hospitalization time was 10 to 24 days ,with the average hospitalization time of （15 .6 ± 2 .3） days .CONCLUSION The age over 60 years ,chronic disease and history of smoking are related factors for pulmonary infections .Effective intervention according to the conditions of patients can reduce incidence rate of pulmonary infections .