老年患者腹腔术后发生下呼吸道医院感染危险因素分析

目的 探讨老年患者腹腔手术后发生下呼吸道医院感染危险因素及预防控制对策.方法 对2007年6月至2011年6月外科收治的410份老年腹腔手术患者病历资料进行回顾性调查与前瞻性监测.结果 在410例老年腹腔手术患者中,发生医院感染98例,其中下呼吸道感染43例,感染率为10.5％,占医院感染部位的43.9％;下呼吸道感染中革兰阴性菌占76.6％;吸烟史、术后使用呼吸机、慢性呼吸道疾病、脑血管意外、手术持续时间、全身麻醉6个变量,为老年患者腹部术后下呼吸道感染的独立危险因素.结论 老年患者腹腔手术后下呼吸道感染中革兰阴性菌耐药性较高,应加强其医院感染危险因素的监测控制与病原菌分布及耐药性分析,有效降低医院感染发生率,减少老年患者腹腔术后的死亡率.

Risk factors for lower respiratory tract infections in elderly patients after abdominal surgery

OBJECTIVE To explore the risk factors for lower respiratory tract infections in elderly patients after abdominal operation so as to propose measures of prevention and control.METHODS The medical records of the 410 patients who underwent abdominal surgery from Jun 2007to Jun 2011 were investigated retrospectively with prospective monitoring.RESULTS Among 410 cases who underwent abdominal surgery,nosocomial infections occurred in 98 cases including 43(10.5%) cases with lower respiratory tract infections,lower respiratory tract accounted for 43.9% among the infection sites;gram-negative bacteria causing lower respiratory tract infections accounted for 76.6%.CONCLUSION The six variables including the smoking history,mechanical ventilation after surgery,history of chronic respiratory disease,history of cerebaral vascular stroke,duration of the surgery and general anesthesia are the independent risk factors for the lower respiratory tract infections in the elderly patients after abdominal surgery,the drug resistance of gram-negative bacteria causing lower respiratory tract infections is serious,it is necessary to enhance the monitoring and control of the risk factors for nosocomial infections and analyze the distribution and drug resistance in further step so as to effectively reduce the incidence of nosocomial infections and the mortality of the elderly patients after abdominal surgery.