口腔颌面手术全身麻醉术后下呼吸道感染的危险因素分析

目的：：分析口腔颌面手术患者气管插管全身麻醉后下呼吸道感染发生的原因。方法：收集我院自2013年1月至2014年12月气管插管全身麻醉下行口腔颌面部手术的患者424例作为研究对象,详细记录其基本信息及相关病史,追踪术后并发下呼吸道感染者例数,分析下呼吸道感染发生的可能原因。结果：424例患者有423例患者得到完整随访,发生下呼吸道感染者20例,发生率为4.73％；多因素分析结果表明术前无口腔护理、感染性疾病手术、急症手术、手术持续时间大于3h、吸烟史、既往慢性呼吸系统感染和年龄等因素为全麻后下呼吸道感染的危险因素( P<0.05)。结论：气管插管全身麻醉下口腔颌面部手术的患者,如果高龄或系感染性疾病手术、急症手术、手术持续时间大于3h,既往慢性呼吸系统感染及吸烟史,那么气管插管全麻后发生下呼吸道感染危险会明显增高。

Risk Factor Analysis of Postoperative Lower Respiratory Tract Infection in Patients Undergoing Oral and Maxillofacial Surgeries Under General Anesthesia

Objective:To explore the reason for postoperative lower respiratory tract infection in patients undergoing oral and maxillofacial surgeries under general anesthesia in order to guide the clinical prevention and treatment. Methods:The continuous clinical data of 424 patients who neeed oral and maxillofacial surger-ies under general anesthesia from Jan 2013 to Dec 2014 were collected with the general information, then the number of patients who had postoperative lower respiratory tract infection was recorded. Results: Of 423 pa-tients with complete data, lower respiratory tract infection occurred postoperatively in 20 cases with the inci-dence rate of 4.73%. The multivariate analysis indicated that infectious operation, emergency operation, oper-ation time over 3 hours, history of chronic respiratory tract infection, advanced age and smoking? history were risk factors of lower respiratory tract infection. Conclusion:The risk of getting postoperative lower respiratory tract infection would increase if patient who was old or had smoking history,or history of chronic respiratory tract infection, undergo infectious oral and maxillofacial surgeries or emergency operations, or operation time over 3 hours, under general anesthesia.