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目的分析老年创伤患者术后感染的相关危险因素及感染病原菌分布,以降低肺部感染率。方法回顾性分析2011年1月-2013年12月老年创伤手术患者705例临床资料,分析患者的性别、年龄、卧床时间、吸烟、麻醉方式、手术时间、基础疾病数、呼吸道病史、受伤至就诊的时间等各种不同因素与其发生肺部感染的相关性。结果 705例老年创伤手术患者中发生肺部感染68例感染率为9.65%,检出病原菌89株,以铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌、溶血葡萄球菌感染居多,分别占28.09%、14.61%、24.72%、12.36%;老年创伤手术患者年龄、糖尿病史、住院时间、麻醉方法、手术时间等多种因素与肺部感染相关(P<0.05),其中手术时间对发生肺部感染的影响最大(OR值为12.81)。结论老年患者年龄越大、手术时间长、全身麻醉、糖尿病、卧床时间等多种危险因素与肺部感染相关,尽量缩短手术时间、选择合适麻醉方式、加强护理等措施减少肺部感染的发生。
Objective To analyze the risk factors of postoperative infection in elderly trauma patients and the distribution of infectious pathogens in order to reduce the rate of lung infection. Methods The clinical data of 705 elderly patients with traumatic surgery from January 2011 to December 2013 were analyzed retrospectively. The patients’ gender, age, bed rest, smoking, anesthesia, operation time, number of underlying diseases, respiratory history, Time and other factors associated with their occurrence of pulmonary infection. Results Among the 705 elderly traumatic patients, the infection rate of 68 cases was 9.65%. 89 pathogens were detected, most of which were Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus and Staphylococcus haemolyticus, Respectively, accounting for 28.09%, 14.61%, 24.72% and 12.36% respectively. The age, diabetes history, hospitalization time, anesthesia method, operation time and other factors in elderly patients with traumatic surgery were associated with pulmonary infection (P <0.05) Pulmonary infection has the greatest impact (OR = 12.81). Conclusion The elderly patients with older age, long operation time, general anesthesia, diabetes, bed time and other risk factors associated with pulmonary infection, try to shorten the operation time, choose the appropriate anesthesia, care and other measures to reduce the incidence of pulmonary infection.