患者术后肺部感染与麻醉的相关性研究

Relevance between postoperative infections and anesthesia

目的探讨患者术后发生肺部感染与麻醉的相关性,为降低术后感染率提供临床依据。方法选择2013年1月-2015年1月医院接诊的702例手术患者临床资料进行研究,对比分析患者术后肺部感染率、术后影响因素、麻药吸入及病原菌分布,数据采用SPSS18.0软件进行统计分析。结果 702例手术患者术后发生肺部感染60例,感染率8.55%;术后肺部感染患者的科室、麻醉方式、基础疾病、手术时间及麻醉时间等相关因素及其感染率对比,差异有统计学意义(P<0.05);术后肺部感染患者吸入麻药46例,占76.67%,未吸入麻药14例,占23.33%,差异有统计学意义(P<0.05);肺部感染患者共检出病原菌60株,其中革兰阴性菌41株占68.34%,革兰阳性菌13株占21.66%,真菌6株占10.00%。结论患者术后发生肺部感染与麻醉方式、麻醉时间及吸入麻药等有关,有效积极治疗基础疾病、强化术前评估、选择恰当的麻醉方式,加强术中无菌管理、合理化使用抗菌药物均是降低术后肺部感染很有效的措施。

OBJECTIVE To investigate the relevance between postoperative pulmonary infections and anesthesia ,so as to provide clinical evidence for reduction of postoperative infection rates .METHODS The clinical data of 702 ca‐ses received surgeries and admitted from Jan .2013 to Jan .2015 were studied .The postoperative lung infection rate ,influencing factors ,inhalation of anesthesia drug and pathogen distribution were compared and analyzed sta‐tistically by SPSS 18 .0 software .RESULTS Totally 60 cases of patients appeared pulmonary infections in 702 pa‐tients ,and the infection rate was 8 .55% .Infection rates in different departments of lung infected patients ,ways of anesthesia ,underlying diseases ,surgical time and anesthesia time were obviously different and the differences were significant （P〈0 .05） .There were 46 cases inhaled anesthesia cases ,accounting for 76 .67% ;14 cases didn＇t inhale anesthesia drug ,accounting for 23 .33% .The differences were significant （P〈0 .05） .In patients with postoperative pulmonary infections ,60 strains of pathogens were detected ,including 41 strains of gram‐negative bacteria ,accounting for 68 .33% ;13 strains of gram‐positive bacteria ,holding 21 .67% and 6 strains of fungi , reaching 10 .00% .CONCLUSION Postoperative pulmonary infection is related to ways of anesthesia ,Effective measures to reduce postoperative lung infections include effective treatment of basic diseases ,strengthening of pre‐operative assessment ,proper ways of anesthesia ,intensified management of sterility during operations and rational use of antibiotics .