麻醉相关因素与下呼吸道医院感染的研究

目的探讨气管插管全身麻醉患者院内下呼吸道感染的相关因素和有效的预防措施。方法从麻醉机回路内、病毒/细菌过滤器和气管插管全身麻醉患者口腔和支气管内吸取的分泌物做细菌培养。结果术前采样的15台未消毒的麻醉机中有8台细菌培养呈阳性;每例患者术中口腔、支气管分泌物及术后病毒/细菌过滤器均分离出相同细菌;使用一次性病毒/细菌过滤器的病例,术后从麻醉机内和一次性病毒/细菌过滤器麻醉机采样未捡出细菌;未使用一次性病毒/细菌过滤器的病例,术后麻醉机内可分离出与口腔相同的细菌。结论研究结果提示麻醉机很易受到手术患者的污染,而麻醉机的循环使用可将病原菌传播到下一个手术患者,是导致气管插管全身麻醉患者手术后下呼吸道医院感染的重要因素。

Nosocomial Lower Respiratory Infection and General Anesthesia: A Risk Factor Analysis and Prophylaxis

OBJECTIVE To explore the factors and effective preventive method of nosocomial lower respiratory(infection) after general anesthesia through trachea intubation.METHODS Using bacterial culture and identification technique to detect the samples collected from pipe and the sides of anesthetic machine,from disposable virus/(bacteri)a respiratory filter and buccal and bronchial secretion of patients with general anesthesia through trachea(intubation.) RESULTS Eight of 15 anesthetic machines without disinfection were with positive bacterial culture.All sides of virus/bacteria respiratory filter,and buccal and bronchial secretion of patients during operation had same(bacteria.) No bacteria growth was found in anesthetic machine and disposable virus/bacteria respiratory filter used after operation.The same bacteria as from buccal secretion were isolated from anesthetic machine in patients(without) using virus/bacteris respiratory filter.CONCLUSIONS The(results) showed the anesthetic machine is more easy to be contaminated by patients,and the reuse of anesthetic machine is an important factor for nosocomial(lower) respiratory infection after general anesthesia through trachea intubation.Intensifying periodic disinfection of(anesthetic) machine and using virus/bacteria respiratory filter can prevent contamination between anesthetic(machine) and patients and decrease nosocomial lower respiratory(infection) after operation.