摘要
目的探讨重症呼吸衰竭患者气管插管术后肺部感染的病原菌分布特点,并分析其影响因素。方法选取2019年1月一2024年10月期间于某医院接受气管插管手术治疗的369例重症呼吸衰竭患者进行研究,根据其术后是否发生肺部感染分为感染组和对照组,比较2组临床资料差异,并对其感染病原菌分布特点和危险因素进行分析。结果本研究中重症呼吸衰竭患者术后肺部感染率为9.21%,检出58株病原菌;其中革兰阴性菌占77.59%,以铜绿假单胞菌、鲍曼不动杆菌为主;革兰阳性菌占25.86%,以葡萄球菌属为主。logistic分析显示,年龄≥60岁、糖尿病、高血压、低蛋白血症、插管时间≥7h、拔管延迟、抗菌药物使用不当、盲探/经口插管及插管过深均为独立危险因素(P<0.05)。预测模型AUC为0.772(灵敏度83.78%,特异度66.41%)。结论重症呼吸衰竭患者气管插管术后肺部感染的发生与多种因素密切相关,临床工作中应针对这些危险因素采取相应的预防措施,以降低肺部感染的发生率,改善患者预后。
Objective To explore the distribution characteristics of pathogenic bacteria in patients with severe respiratory failure who underwent endotracheal intubation and pulmonary infections,and to analyze their influencing factors.Methods A total of 369 patients with severe respiratory failure who underwent endotracheal intubation surgery in our hospital from January 2019 to October 2024 were selected for the study.They were divided into an infection group and a control group based on whether they developed pulmonary infection after surgery.The differences in clinical data between the two groups were compared,and the distribution characteristics and risk factors of infectious pathogens were analyzed.Results The postoperative pulmonary infection rate in patients with severe respiratory failure in this study was 9.21%,and 58 strains of pathogenic bacteria were detected;Among them,Gram negative bacteria accounted for 77.59%,mainly Pseudomonas aeruginosa and Acinetobacter baumanni;Gram positive bacteria accounted for 25.86%,mainly Staphylococcus genus.Logistic analysis showed that age≥60 years,diabetes,hypertension,hypoproteinemia,intubation time≥7 h,delayed extubation,improper use of antibiotics,blind probe/oral intubation and too deep intubation were independent risk factors(P<0.05).The AUC of the prediction model was 0.772(sensitivity 83.78%,specificity 66.41%).Conclusion The occurrence of pulmonary infection in patients with severe respiratory failure after tracheal intubation is closely related to multiple factors.In clinical practice,corresponding preventive measures should be taken to reduce the incidence of pulmonary infection and improve patient prognosis based on these risk factors.
作者
方顺金
沈健
苏耀
FANG Shun-jin;SHEN Jian;SU Yao(Huzhou Third People's Hospital,Huzhou 313000,China)
出处
《中国消毒学杂志》
2025年第7期511-515,共5页
Chinese Journal of Disinfection
关键词
重症呼吸衰竭
气管插管
肺部感染
病原菌
影响因素
severe respiratory failure
endotracheal intubation
pulmonary infection
pathogenic bacteria
influencing factors
