剖胸术后下呼吸道菌群变化的分析及护理

对３７例剖胸手术患者术前及术后第３ｄ痰标本进行细菌培养，结果表明，术前３７例在气管插管前后，取下呼吸道分泌物作细菌培养，无１例病菌或条件致病菌生长；而术后第３ｄ取痰培养，１７例阳性，占４５．９％，其中有革兰氏阴性杆菌１２例，占菌种的７０．６％，革兰氏阳性球菌５例，占２９．４％，以重度吸烟及有慢性支气管炎病中者阳性率更高，据此制定出相应护理措施，加强术前，术后呼吸道管理，减少了下呼吸道感染机率。

Observation on the Flora Changes in Lower Respiratory Tract after Thoracotomy and Nursing

The sputum bacteria culture of 37 patients with thoracotomy was performed before operation,and at the postoperative 3rd day.The samples were obtained from the secretion in lower respiratory tract through the insertion of a endotrachea tube.It was found that no pathogenic or conditioned pathogenic bacteria was grown in the culture in the 37 patients before the operation.However.after the operation,bacteria culture were positive in 17 cases(45.9%).The cultured bacteria included gram-positive in 12 cases(70.6%)and gram-negative in 5 cases(29.4%).The patients with chronic bronchitis and smoking had a higher positve rate.According to the results,appropriate nursing measures were worked out,including strengthening the management of lower respiratory tract pre- and post-operatively to reduce the op-portunity of infection of lower respiratory tract.