摘要
目的分析术后耐甲氧西林金黄色葡萄球菌(MRSA)肺炎相关危险因素,以制定有效的防护措施。方法回顾性收集2007年10月—2008年12月我院急症和择期手术后确诊为肺炎的406例病人的资料,用SPSS软件分析术后MRSA肺炎相关危险因素。结果确诊MRSA肺炎33例,检出率为8.12%,死亡8例,病死率24.2%。单因素相关分析筛选出术后MRSA肺炎发病的8项可能危险因素:年龄≥60岁、住院≥20 d、广谱抗生素使用>10 d、颅脑手术、气管插管或切开(未行机械通气)、机械通气、深静脉置管、抑酸剂的应用。多因素Logistic回归分析提示,住院≥20 d、广谱抗生素使用>10 d、颅脑手术、气管插管或切开是术后MRSA肺炎发病的独立危险因素。结论住院≥20 d、广谱抗生素使用>10 d、颅脑手术、气管插管或切开是术后MRSA肺炎发病的独立危险因素,需要综合预防才能降低其发病率。
Objective To analyze risk factors that cause postoperative methicillin-resistant staphylococcus aureus（MRSA） pneumonia,and set up protective strategies. Methods Clinical data of 406 patients with postoperative pneumonia afteracute or selected surgery,between Oct.2007 and Dec.2008,were reviewed.Postoperative-MRSA-pneumonia-related risk factors were analyzed with SPSS software. Results Thirty-three patients developed postoperative MRSA pneumonia,the detection rate was 8.12%.Eight patients（24.2%） died.The eight possible risk factors of postoperative MRSA pneumonia,identified with univariate Pearson Chi-Square test,were age ≥60 years,hospital stay ≥20 d,broad-spectrum antibiotics usage（10 d）,brain surgery,endotracheal intubation or incision（without mechanical ventilation）,mechanical ventilation,intravenous catheter,and the application of acid suppression agents.Multivariable logistic regression analysis revealed that hospitalization ≥ 20 d,broad-spectrum antibiotics 10 d,brain surgery,endotracheal intubation or incision were independent risk factors of postoperative MRSA pneumonia. Conclusion Hospital stay ≥20 d,broad-spectrum antibiotics application 10 d,brain surgery,and endotracheal intubation or incision are independent risk factors of postoperative MRSA pneumonia.Only comprehensive prevention is carried out,can we reduce the morbidity of MRSA.
出处
《齐鲁医学杂志》
2011年第3期235-237,239,共4页
Medical Journal of Qilu
关键词
肺炎
葡萄球菌
金黄色
甲氧西林抗药性
手术后并发症
危险因素
pneumonia
staphylococcus aureus
methicillin resistance
postoperative complications
risk factors
