摘要
目的：探讨体外循环不停跳冠脉搭桥（OPCAB）术后感染的危险因素及其对策。方法：选取2013年1月至2015年9月行OPCAB治疗患者235例为研究对象,根据术后感染的发生情况分为感染组（n=32）和未感染组（n=203）,并对OPCAB术后感染的危险因素进行分析。结果：单因素分析结果显示年龄、病程、心功能、营养状况、气管侵入性操作、抗菌药物应用、住院时间和吸烟均与OPCAB术后感染相关（P〈0.05）。Logistic多元回归分析法结果显示,年龄（OR=9.684,95%CI：2.378~16.452）、病程（OR=9.828,95%CI：2.554~17.628）、心功能（OR=7.841,95%CI：1.958~12.256）、营养状况（OR=7.967,95%CI：2.016~13.748）、气管侵入性操作（OR=9.927,95%CI：2.728~18.157）、抗菌药物应用（OR=9.763,95%CI：2.455~17.428）和住院时间（OR=9.702,95%CI：2.382~16.828）均为OPCAB术后感染的独立相关因素。结论：OPCAB术后感染的危险因素有年龄、病程、心功能、营养状况、气管侵入性操作、抗菌药物应用和住院时间等。延长抗菌药物应用时间、缩短住院时间、减少气管侵入性操作、改善营养状况和心功能、加强对较大年龄和较长病程患者的干预有利于预防OPCAB术后感染的发生。
Objective： To evaluate the risk factors and countermeasures of infection in patients with on-pump coronary artery bypass grafting（OPCAB）. Methods： 235 patients undergone OPCAB from January 2013 to September 2013 were selected. According to the occurrence of postoperative infection, patients were divided into infected group（n = 32） and uninfected group（n = 203）. Using single factor analysis method and the analysis of Logistic multivariate regression analysis, the risk factors of postoperative infection and the corresponding countermeasures were analyzed. Results： Single factor analysis showed that age, course of the disease, cardiac function, nutritional status, trachea of invasive operation, the application of antimicrobial agents, the length of hospital stay, and smoking are associated with postoperative infection in OPCAB（P 〈 0.05）. Logistic multivariate regression analysis results showed that age（OR = 9.684,95%CI： 2.378 ~ 16.452）, course of the disease（OR =9.828,95%CI： 2.554 ~ 17.628）, cardiac function（OR = 7.841,95%CI：1.958~12.256）, nutritional status（OR =7.967,95%CI： 2.016 ~ 13.748）, trachea of invasive operation（OR = 9.927,95%CI： 2.728 ~ 18.157）, antimicrobial application（OR = 9.763,95%CI： 2.455 ~ 17.428）and length of hospital stay（OR = 9.702,95%CI： 2.382 ~16.828）were independent factors associated with postoperative infection in OPCAB（P 〈 0.05）. Conclusions： The postoperative infection risk factors of OPCAB are age, course of the disease, cardiac function, nutritional status,trachea of invasive operation, antimicrobial application and the length of hospital stay. The extended time of antimicrobial application, the shortened the length of hospital stay, the reduced the invasive operation of trachea,the improved nutritional status and cardiac functions, and the strengthened and extended interventions to the older are all beneficial to prevent the postoperative infection in OPCAB patients.
出处
《泸州医学院学报》
2016年第2期163-165,共3页
Journal of Luzhou Medical College
关键词
体外循环
不停跳冠脉搭桥术
感染
危险因素
对策
Extracorporeal circulation
On-pump Coronary Artery Bypass Grafting
Infection
Risk factors
Countermeasures
