【摘要】 目的分析腹部手术全身麻醉患者术后并发肺部感染的情况,探讨预防的措施,以降低感染发生率。方法以2007年1月-2012年1月全身麻醉下行腹部手术的800例住院患者为研究对象,回顾性分析患者的临床资料与肺部感染发生的关系。结果 800例患者中术后并发肺部感染56例,感染率为7.0%;检出革兰阴性菌32株,占57.1%,包括铜绿假单胞菌16株、大肠埃希菌13株、阴沟肠杆菌3株;革兰阳性菌18株,占32.1%,包括金黄色葡萄球菌14株、表皮葡萄球菌2株、溶血性链球菌2株;真菌6株;肺部感染年龄≥50者发生率为11.7%,高于年龄<50者的3.3%;有吸烟史者发生率16.0%,高于无吸烟史者的2.9%;上腹部手术患者9.0%,高于下腹部的3.6%;手术时间≥2h者为10.0%,高于<2h者的4.1%;术后锻炼开始时间较晚者感染率9.8%,高于锻炼开始较早者的3.4%;伴有呼吸系统基础疾病者肺部感染率为30.0%,高于无呼吸系统基础疾病者的3.7%;有其他合并症者19.3%,高于无合并症者的4.1%,且差异均有统计学意义(P<0.05)。结论腹部手术全身麻醉患者肺部感染的发生与患者年龄、吸烟史、手术部位、手术时间、术后锻炼开始的时间、呼吸系统基础疾病、其他合并症相关。更多还原

【Abstract】 OBJECTIVE To analyze the related factors of postoperative pulmonary infections in the patients who underwent the abdominal surgery under general anesthesia and explore the prevention measures so as to reduce the incidence of infections.METHODS From Jan 2007 to Jan 2012,800 cases of hospitalized patients undergoing abdominal surgery under general anesthesia were chosen as the research objects,the correlation between the clinical data of the patients and the incidence of pulmonary infections was retrospectively analyzed.RESULTS Of totally 800 patients,the pulmonary infections occurred in 56 cases with the infection rate of 7.0%.There were 32 cases(57.1%) with gram-negative bacteria infections,including 16 cases with Pseudomonas aeruginosa infections,13 cases with Escherichia coli infections,and 3 cases with Enterobacter cloacae infections;there were 18 cases(32.1%) with gram-positive bacteria infections,including 14 cases with Staphylococcus aureus infections,2 cases with Staphylococcus epidermidis infections,and 2 cases with Streptococcus hemolytic infections;there were 6 cases with fungal infections.The incidence rate of the pulmonary infections in the patients aged more than 50 years old was 11.7%,higher than 3.3% of the patients aged less than 50 years old;the incidence rate of the patients with smoking history was 16.0%,higher than 2.9% of the patients without smoking history;the incidence rate of the patients undergoing the upper abdominal surgery was 9.0%,higher than 3.6% of the patients undergoing the lower abdominal surgery(P<0.05);the incidence rate of the patients with operation time more than 2 hours was 10.0%,higher than 4.1% of the patients with operation time less than 2 hours;the incidence of the patients starting to exercise very late after the surgery was 9.8%,higher than 3.4% of the patients starting early;the incidence of the patients with respiratory system underlying diseases was 30.0%,higher than 3.7% of the patients without the underlying diseases;the incidence of the patients with other complications was 19.3%,higher than 4.1% of the patients without other complications,the difference was statistically significant(P<0.05).CONCLUSION The incidence of the pulmonary infections in the patients undergoing abdominal surgery under general anesthesia is related to the age,smoking history,surgical site,operation duration,start of exercise after the surgery,underlying diseases of the respiratory system,and other complications.更多还原