摘要
目的回顾性分析老年患者气管插管全麻后下呼吸道感染患者的临床资料,并对下呼吸道感染相关的危险因素进行筛选,确定危险因素以便指导临床治疗。方法选取行上腹部手术治疗并接受气管插管全身麻醉的老年患者414例,对其临床资料进行分析,采用单因素χ2检验及logistic回归分析在年龄、性别、吸烟史、慢性呼吸系统疾病、基础心脑血管疾病、糖尿病、麻醉持续时间等因素中筛选并确定老年患者气管插管全身麻醉发生下呼吸道感染的危险因素。结果单因素分析显示,吸烟史、慢性呼吸系统疾病史及麻醉持续时间>3h患者气管插管全身麻醉后下呼吸道感染率分别为22.16%、17.47%、19.07%,差异有统计学意义(P<0.05);logistic回归分析最终确定吸烟史(OR=2.393,P<0.005)、慢性呼吸系统疾病(OR=2.110,P<0.005)以及麻醉持续时间>3h(OR=1.904,P<0.001)为导致老年患者发生气管插管全身麻醉后下呼吸道感染的危险因素。结论应根据老年患者气管插管全麻后下呼吸道感染危险因素对该并发症进行预防。
OBJECTIVE To retrospectively analyze the clinical data of the elderly patients with lower respiratory tract infections who underwent the tracheal intubati0n under general anesthesia and screen the risk factors so as to guide the clinical treatment. METHODS A total of 414 elderly patients who received upper abdominal surgeries under general anesthesia were enrolled in the study, and the clinical data were analyzed. The univariate analysis and the multivariate analysis were preformed to determine the risk factors of the lower respiratory tract infections, including the age, gender, smoking history, chronic respiratory diseases history, basic cardiovascular disease, diabetes, and duration of anesthesia. RESULTS The univariate analysis indicated that the incidence rate of lower respiratory tract infections was 22.16 % in the patients with smoking history, 17.47 % in the patients with chronic respiratory disease, and 19.07% in the patients with the duration of anesthesia more than 3 hours, the difference was statistically significant（P〈0.05） ; the logistic regression analysis showed that the smoking history （OR = 2. 393;P〈0. 005）, chronic respiratory disease history （OR= 2. 110;P〈0. 005） and the duration of anesthesia more than 3 hours （OR= 1. 904;P〈20. 001） were determined as the risk factors for the lower respiratory tract infections in the elderly patients after tracheal intubation under general anesthesia. CONCLUSION The lower re- spiratory tract infections should be prevented according to the risk factors after tracheal intubation under general anesthesia.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第7期1586-1587,共2页
Chinese Journal of Nosocomiology
关键词
气管插管
全身麻醉
下呼吸道感染
Tracheal intubation
General anesthesia
Lower respiratory tract infection
