肺、食管手术中的细菌调查

目的　了解肺、食管手术中可能受到的各种内源性、外源性细菌污染 ,以利更好地控制手术后感染。方法　对 44 9例肺、食管择期手术患者的食管腔或支气管腔以及手术室空气、手术人员手作细菌学检查。　结果　肺、食管手术后感染发病率为 7.8% ,术后感染是肺、食管手术重要的并发症。食管手术患者食管腔内含有大量细菌 ,如甲型链球菌、肠道杆菌、绿脓杆菌等 ,而支气管腔内细菌较少 ,以甲型链球菌为主。手术室空气中主要致病菌为金黄色葡萄球菌 ,手术人员洗手后手上主要细菌为表皮葡萄球菌。　结论　与支气管腔相比 ,食管腔中所含的大量细菌可能严重污染手术野 ,成为食管手术后感染重要的内源性细菌。

Bacterial Survey During Pulmonary and Esophageal Surgery

Objective To evaluate the exogenous and endogenous contaminating bacteria during pulmonary and esophageal surgery, in order to prevent postoperative infections efficiently. Methods The esophageal and bronchial lumens of 449 patients undergoing elective pulmonary and esophageal operations, the air of operating rooms and the hands of operating personnel were bacteriological analyzed. Results The incidence of postoperative infection in pulmonary and esophageal surgery was 7.8%, which was an important postoperative complication. There were a large quantity of bacteria in the esophageal lumens, such as Streptococcus viridans, enteric bacilli, Pseudomonas aeruginosa, while a small quantity of bacteria in the bronchial lumens, most of them were Streptococcus viridans. Staphylococcus aureus was the main pathogenic bacteria in the air of operating rooms, Staphylococcus epidermidis was the major bacteria on the hands of operating personnel. Conclusion Bacteria in the esophageal lumens would contaminate surgical fields more serious than that in bronchial lumens, and may play a causal role in the development of postoperative infections in esophageal surgery.