无痛胃镜并发呼吸道感染发生情况及影响因素

目的 分析无痛胃镜并发呼吸道感染的发生情况,探讨降低无痛胃镜并发呼吸道感染的措施。方法 对内江市某医院2015—2018年住院患者无痛胃镜并发呼吸道感染发生情况进行调查,并对无痛胃镜并发呼吸道感染相关因素进行分析。结果 共纳入无痛胃镜受检者3 316例,其中男性1 976例,占59.6%,女性1 340例,占40.4%,年龄23~74岁,平均年龄（57.63 ± 7.59）岁,病程1~47个月,平均病程（6.2 ± 2.1）个月,中位数为7个月。102例为无痛胃镜并发呼吸道感染,感染率为3.08%（102/3 316）。共分离出病原菌115株,其中革兰阴性菌75株,占65.22%,革兰阳性菌28株,占24.35%,真菌12株,占10.43%。主要革兰阴性菌和革兰阳性菌对大多数A类抗菌药物的耐药率均低于30%。多因素logistic回归分析结果显示年龄≥56岁（OR=14.984）,胃镜时长>20 min（OR=14.761）及术后24 h内进食刺激性食物（OR=1.669）是无痛胃镜并发呼吸道感染的危险因素。结论 无痛胃镜存在引发呼吸道感染的风险,高龄、胃镜时长及术后刺激性食物均能增加术后呼吸道感染风险,应采取相应的干预措施,降低无痛胃镜并发呼吸道感染的风险。

Risk factors for complications of respiratory tract infection undergoing painless gastroscopy

Objective To analyze related factors of patients complicated with respiratory tract infection （RTI） treated by painless gastroscopy, so as to explore measures to reduce the complication of RTI. Methods The incidence of RTI in inpatients undergoing painless gastroscopy from 2015 to 2018 in a hospital in Neijiang City was investigated, and the related factors of painless gastroscope complicated with RTI were analyzed. Results A total of 3 316 inpatients undergoing painless gastroscopy were investigated, including 1 976 males （59.6%） and 1 340 females （40.4%）.The age ranged from 23 to 74 years, with an average age of （57.63 ± 7.59） years. Of the patients, 102 were complicated with RTI, with an infection rate of 3.08% （102/3 316）.A total of 115 strains of pathogens were isolated, including 75 strains of Gram-negative bacteria （65.22%）, 28 strains of Gram-positive bacteria （24.35%）, and 12 strains of fungi （10.43%）.The resistance rates of major Gram-negative and Gram-positive bacteria to most Class A antibiotics were lower than 30%.Multivariate logistic regression analysis showed that age ≥56 years （OR=14.984）, duration for gastroscope >20 minutes （OR=14.761） and eating stimulating food within 24 hours after gastroscopy （OR=1.669） were risk factors for complication of RTI after undergoing the painless gastroscopy. Conclusion Painless gastroscopy had the risk for complication of RTI. Age, duration for gastroscopy and stimulating food after operation can increase the risk of RTI after undergoing the painless gastroscopy.