摘要
目的分析老年患者气管插管全身麻醉术后感染病原菌分布,研究其对血清缝隙连接蛋白表达的影响,为临床诊断、治疗提供参考。方法选取2014年3月-2015年5月医院诊治的100例老年气管插管全身麻醉术后感染患者为研究对象,设为感染组,以医院同期老年气管插管全身麻醉术后未感染患者100例作为未感染组,另选健康体检者100名作为对照组;统计感染组患者的病原菌分布及感染部位构成比,对比3组受试人员血清中缝隙连接蛋白及炎症因子水平的变化。结果 100例老年气管插管全身麻醉术后感染患者共分离病原菌100株,其中革兰阳性菌53株占53.0%,以肺炎链球菌和酿脓链球菌为主,革兰阴性菌47株占47.0%,以肺炎克雷伯菌和铜绿假单胞菌为主;感染部位以肺部感染为主占46.0%,其次为上呼吸道、下呼吸道和皮肤,分别占22.0%、17.0%和11.0%;老年气管插管全身麻醉患者感染病原菌后血清中缝隙连接蛋白30、33、40、43水平明显低于对照组和未感染组患者,且差异有统计学意义(P<0.01);感染患者血清中瘤坏死因子α、白细胞介素-2、干扰素γ及C-反应蛋白水平明显高于对照组和未感染组,差异有统计学意义(P<0.01)。结论老年气管插管全身麻醉患者术后容易受到病原菌感染,且感染引起患者血清中炎症反应增强及缝隙连接蛋白水平的显著降低。
OBJECTIVE To investigate the distribution of pathogens causing postoperative infections in elderly endotracheal intubation patients after general anesthesia and observe the impact on expression of serum connexins so as to provide guidance for clinical diagnosis and treatment.METHODS From Mar 2014 to May 2015,a total of 100 elderly endotracheal intubation patients who were complicated with infections after general anesthesia were recruited as the study objects and set as the infection group,meanwhile,100 elderly endotracheal intubation patients who were not complicated with infections after general anesthesia were chosen as the non-infection group,and 100 healthy people who received physical examination were set as the control group.the distribution of pathogens and constituent ratios of infection sites were statistically analyzed,the changes of levels of serum connexins and inflammatory factors were observed and compared among the three groups of patients.RESULTS Totally 100 strains of pathogens were isolated from 100 elderly endotracheal intubation patients who were complicated with postoperative infections after general anesthesia,including 53(53.0%)strains of gram-positive bacteria and 47(47.0%)strains of gram-negative bacteria;the Streptococcus pneumoniae and Streptococcus pyogenes were dominant among the gram-positive bacteria;the Klebsiella pneumoniae and Pseudomonas aeruginosa were the predominant species of gram-negative bacteria.Among the patients with infections,46.0% had pulmonary infections,22.0% had upper respiratory tract infections,17.0% had lower respiratory tract infections,and 11.0% had skin infections.The levels of serum connexin 30,33,40,and 43 of the elderly endotracheal intubation patients with infections were significantly lower than those of the patients in the non-infection group and the people in the control group(P〈0.01).The levels of serum tumor necrosis factorα,interleukin-2,interferonγ,and C-reactive protein of the infection group were significantly higher than those of the control group and the non-infection group(P〈0.01).CONCLUSION The elderly endotracheal intubation patients tend to be infected with pathogens after general anesthesia,and the infections may lead to the enhancement of serum inflammatory reaction and significant reduction of the levels of connexins.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第9期2047-2049,共3页
Chinese Journal of Nosocomiology
基金
河北省重点基础研究基金资助项目(2014055468)
关键词
气管插管
全身麻醉
病原菌分布
炎症反应
Endotracheal intubation
General anesthesia
Distribution of pathogen
Inflammatory reaction