口腔颌面肿瘤术后呼吸道感染相关因素分析

Analysis of Related Factors Affecting Respiratory Tract Infection after Oral and Maxilloficiai Surgery

目的 调查和分析口腔颌面肿瘤患者术后呼吸道感染的相关因素,探讨有效控制和降低呼吸道感染发病率的措施。方法 采用回顾性调查方法对我院口腔颌面肿瘤病区2000年1月～2001年12月63例院内获得性呼吸道感染病例进行调查、统计和分析。结果 口腔颌面肿瘤患者术后呼吸道感染以下呼吸道为主,好发于老年患者,往往与机体免疫力低下(恶性肿瘤本身或者化疗放疗所致)、侵入性操作、制动(组织游离移植术后需要制动)、误吸史(手术创伤致吞咽功能丧失,造成误吸);及细菌耐药等因素相关。结论 (1)加强患者围术期管理(包括严格病区环境、术前后的健康教育、呼吸理疗等);(2)提高侵入性操作的规范性;(3)认真执行无菌操作原则;(4)合理应用抗生素,是降低口腔颌面肿瘤患者院内获得性呼吸道感染的有效措施。

Objective To investigate and analyze related factors affecting respiratory tract infection after oral and maxilloficial surgery, and discuss measures of controlling and reducing the incidence of respiratory tract infection. Methods 63 cases of respiratory tract infection acquired after oral and maxillofacial surgery during hospitalization between Jan. 2000 and Dec. 2001 were retrospectively reviewed and analyzed. Results Respiratory tract infection after oral and maxilloficial surgery occurred mainly in the lower respiratory tract, and more likely in elderly patients. The infections were mainly associated with lower immunity due to postoperative chemotherapy or/and radiotherapy, invasive manipulation, immobilization after microsurgical operation, aspiration due to loss of the deglutitive function, and microbial resistance. Conclusion Effective methods to control and reduce the incidence of respiratory tract infections after oral and maxilloficial surgery should include: 1) improving perioperative management, including the ward environment, health education and respiratory physiotherapy; (2) specifying invasive manipulations; (3) implementing aseptic technique, and(4)rationalizing antibiotic use.