腰椎手术患者全麻术后呼吸道感染的相关因素分析

Risk factor analysis of postoperative respiratory tract infections in patients undergoing lumbar vertebra surgery under general anesthesia

目的探讨气管置管全身麻醉下行腰椎手术患者术后发生呼吸道感染的相关因素,为其临床预防治疗提供参考依据。方法收集2012年9月-2014年9月在医院住院拟行气管置管全身麻醉下腰椎后路切开减压内固定椎间融合术的患者303例作为研究对象,记录其基本信息及相关病史,分析术后呼吸道感染的相关因素,研究数据采用SPSS 17.0软件进行统计处理。结果 300例患者中发生呼吸道感染34例,感染率为11.33%;多因素分析结果显示,年龄、吸烟史、既往有呼吸系统慢性感染、糖尿病、无口腔护理等因素与术后呼吸道感染有关,差异有统计学意义(P<0.05)。结论气管置管全身麻醉下行腰椎手术患者,如为高龄、吸烟者,既往有慢性呼吸道感染及糖尿病史,术后发生呼吸道感染危险因素明显增高;术前进行规范口腔护理可以降低术后发生呼吸道感染的风险。

OBJECTIVE To explore the related factors for respiratory tract infections in patients undergoing lumbar vertebra surgery under general anesthesia in order to guide the clinical prevention and treatment.METHODS The consecutive clinical data of 300 patients who needed lumbar vertebra surgery under general anesthesia from Sep.2012 to Sep.2014 were collected and the general information and the relative medical history were recorded.The related factors for postoperative respiratory tract infection were analyzed.The data were statistically analyzed by software SPSS 17.0.RESULTS Of 300 patients with complete data,respiratory tract infection occurred in 34 cases with the incidence rate of 11.33%.The multivariate analysis indicated that age,smoking history,history of chronic respiratory tract infection or diabetes mellitus,and oral care were correlated with postoperative respiratory tract infections,with significant difference（P〈0.05）.CONCLUSIONThe risk factors of respiratory tract infections would increase if patients undergoing lumbar vertebra surgery under general anesthesia are old,or had smoking history,or history of chronic respiratory tract infections or diabetes mellitus.Proper preoperative measures of oral care can reduce the risk of postoperative respiratory tract infections.