老年患者气管插管全身麻醉术后并发呼吸道感染的常见影响因素分析

Analysis of Common Influencing Factors of Respiratory Tract Infection After Tracheal Intubation and General Anesthesia in Elderly Patients

目的:探讨老年患者气管插管全身麻醉术后并发呼吸道感染的影响因素。方法:选取2021年1月-2021年12月云南省玉溪市人民医院收治的105例老年全身麻醉气管插管患者,其中24例术后并发呼吸道感染者设为感染组,81例未出现感染设为未感染组,对感染组患者的病原菌分布情况与影响因素进行分析。结果:感染组病原菌感染前五位依次为肺炎克雷伯菌(5例)、鲍曼不动杆菌(4例)、大肠埃希菌(3例)、纹带棒状杆菌(2例)、阴沟肠杆菌(2例);导致老年患者气管插管全麻术后并发呼吸道感染的因素主要包括导管带管时间(≥3 h)、导管置入深浅(长)、插管途径(口腔)、插管方式(明视)、插管不熟练、拔管指征不完全、拔管延迟(≥3 h)以及麻醉时间长(≥3 h),差异具有统计学意义。结论:老年气管插管全身麻醉术后并发呼吸道感染患者主要与导管置入深浅、导管带管时间、插管途径、方式、插管熟练程度、拔管指征、拔管时间(≥3 h)以及麻醉时间等因素有关,需加以防范,以降低感染率。

Objective:To investigate the influencing factors of respiratory tract infection after tracheal intubation and general anesthesia in elderly patients.Methods:A total of 105 elderly patients with tracheal intubation under general anesthesia admitted to People's Hospital of Yuxi City from January 2021 to December 2021 were selected,including 24 patients with postoperative respiratory tract infection(were slected as infection group)and 81 patients without infection(were slected as non-infection group).The distribution and influencing factors of pathogenic bacteria in the infection group were analyzed.Results:In the infection group,the top five infections of pathogenic bacteria were Klebsiella pneumoniae in 5 cases,Acinetobacter baumannii in 4 cases,Escherichia coli in 3 cases,Corynebacterium striatum in 2 cases,and Enterobacter cloacae in 2 cases.Factors leading to respiratory tract infection after tracheal intubation under general anesthesia in elderly patients mainly included catheter time(≥3 h),catheter length(long),intubation route(oral),intubation method(clear vision),unskilled intubation,incomplete extubation indication,delayed extubation(≥3 h)and long anesthesia time(≥3 h),and the difference was statistically significant.Conclusion:Elderly patients with respiratory tract infection after tracheal intubation under general anesthesia are mainly related to the length of catheter,catheter time,intubation route,intubation method,intubation proficiency,extubation indication,extubation time(≥3 h)and anesthesia time,which should be taken precautions to reduce the infection rate.