三种麻醉机通气系统对患者肺部病原微生态的影响研究

The impacts of anesthesia machine ventilation systems on the pathogenic microorganisms in lungs

目的分析不同麻醉机通气系统对患者肺部病原微生态的影响情况。方法选择90例全麻插管手术患者作为研究对象,将其随机分为A组(未干预组)、B组(呼吸过滤器组)和C组(麻醉消毒机组),每组30例,比较患者术后肺部感染发生情况。结果三组在麻醉前进行病原菌检测,检出定植菌株,均为条件致病菌:革兰阳性菌、革兰阴性菌和真菌,主要为微球菌、凝固酶阴性葡萄球菌、芽胞杆菌、棒状杆菌、黄杆菌属、酵母样真菌。三组麻醉机各部位病原菌阳性率比较:麻醉前,三组麻醉机不同部位的病原菌阳性率差异无统计学意义(P>0.05);结束麻醉后,检查麻醉机各端口病原菌阳性检出率,其中C组显著低于A组(P<0.05),A、B两组差异无统计学意义(P>0.05)。B、C两组患者术后肺部感染发生率显著低于A组患者(P>0.05)。结论经过干预的麻醉机通气系统对患者肺部微生态环境的影响较小,患者术后呼吸道感染的发生率显著降低。

Objective To analyse the impact of different anesthesia machine ventilation systems on the pathogenic microbes in lungs.Methods Ninety patients who underwent general anesthesia intubation operation were randomly divided into group A（non intervention group）,group B（respiratory filter group）and group C（anaesthetic disinfection group）,30 cases in each group.The incidences of postoperative pulmonary infection were compared between the groups.Results The most common bacteria in the breathing circuit of anesthesia machine was conditional pathogenic bacteria including Gram positive bacteria,Gram negative bacteria and fungi,with micrococci,coagulase negative staphylococci,bacilli,corynebacteria,flavobacteria spp.,and yeast-like fungi.Before anesthesia,there was no significant difference in the positivity rates of bacteria among the three groups.After anesthesia,the positivity rates of bacteria in the expiration port,inspiration port and gasbag port of anesthesia machine in group C were significantly lower than those in group A（P〈0.05）.The positivity rates of bacteria in each port in group B were similar with those in group A（P〉0.05）.The incidences of lung infection after operation in group B and group C were lower than that in group A（P〈0.05）.Conclusion The incidence of lung infection after operation can be significantly reduced by the application of the disinfection machine or breathing filter in patients undergoing general intubation anesthesia.