先天性心脏病和心脏瓣膜病术后肺部感染的相关因素分析

Related factors analysis of postoperative pulmonary infection of congenital heart disease or heart valve disease

目的探讨心脏手术发生肺部感染的危险因素,探讨术后肺部感染的预防措施。方法应用Microsoft Access XP数据库和SPSS 19.0统计软件,回顾性分析2013年6月至2016年6月开封市中心医院490例心脏疾病病人的临床资料,总结心脏手术后肺部感染的发生情况及其相关因素。结果心脏手术术后发生肺部感染42例,总发生率为8.6%,其中先天性心脏病术后并发肺部感染20例,感染率6.2%;瓣膜置换术后并发肺部感染22例,感染率13.1%。单因素分析提示心脏瓣膜疾病术后肺部感染发生率高于先天性心脏病,在相同因素下,两者感染发生率差异有统计学意义(χ~2=6.676,P=0.010),多因素分析提示手术类型,手术时间与肺动脉高压是肺部感染的独立危险因素。结论心脏瓣膜病术后肺部感染率高于先天性心脏病,手术时间、肺动脉高压是肺部感染的危险因素。

Objective To investigate the risk factors for postoperative pulmonary infection in cardiac surgery,and to explore the preventive measures of postoperative pulmonary infection.Methods Microsoft Access XP database and SPSS19.0 statistic software were used to retrospectively analyze the clinical data of 490 patients with heart disease who underwent surgery in Kaifeng Central Hospital from June 2013 to June 2016.The occurrence of postoperative pulmonary infection and its related factors were summed up.Results Pulmonary infection occurred in 42(8.6%)cases after cardiac surgery,including 20(6.2%)cases of pulmonary infection after surgery on congenital heart disease and 22(13.1%)cases of pulmonary infection after cardiac valve replacement.Single factor analysis suggested that there was a higher incidence of postoperative pulmonary infection in heart valve diseasepatients than congenital heart disease patients.There was a statistical difference in the rate of infection between the two groups of patients under the same circumstances(χ^2=6.676,P=0.010).Multi-factor analysis indicated that operation types,operation time and pulmonary hypertension were independent risk factors for pulmonary infection.Conclusions Pulmonary infection is more commonly found in heart valve disease patients than congenital heart disease patients after surgery.Operation time and pulmonary hypertension are risk factors for pulmonary infection.