摘要
目的了解先天性心脏病患儿手术后下呼吸道感染的病原菌分布及其影响因素,探讨有效的预防措施。方法对2000年7月至2004年6月广州市儿童医院收治的483例先天性心脏病术后机械通气的患儿进行下呼吸道分泌物细菌培养和药物敏感试验。结果21例(4.3%)下呼吸道分泌物培养致病菌阳性,共分离出35株细菌。经治疗后20例下呼吸道感染治愈,1例(3.8%)治疗无效死亡。年龄小、体外循环时间及机械通气时间长、2次插管及发生并发症者下呼吸道感染率较高(P<0.01)。结论术后早期对疑有下呼吸道感染者,应积极进行病原学检查,选择敏感的抗生素控制感染。缩短手术和机械通气时间、合理使用呼吸机、减少2次插管和并发症,对预防下呼吸道感染有重要的意义。
Objective To investigate the category of germ and the concerned factors inducing postoperative lower respiratory tract infection after open heart surgery in patients with congenital heart malformations and to explore the prevention measures.Methods The germ cultures of secretion specimens obtained from lower respiratory tract and drug sensitive test were conducted in 483 patients during mechanical ventilation after open heart surgery from July 2000 to June 2004.Results Thirty-five germ strains were isolated in 21 patients（4.3%）;20 patients were cured,and one died（3.8%）.The incidence of lower respiratory tract infection was higher in patients with low patient age,longer extracorporal circulation time and mechanical ventilation duration,twice intubations and complications（P〈0.01）.Conclusion Etiology diagnosis and specific antibiotics are indicated when the patients are suspected of lower respiratory tract infection after open heart surgery.The measures such as shortening extracorporal circulation time and mechanical ventilation duration,performing mechanical ventilation appropriately and reducing twice intubations and complications are important in prophylaxis of lower respiratory tract infection.
出处
《中国实用儿科杂志》
CSCD
北大核心
2008年第4期301-303,共3页
Chinese Journal of Practical Pediatrics
关键词
先天性心脏病
心脏直视手术
机械通气
下呼吸道感染
Congenital heart malformation
Open heart surgery
Mechanical ventilation
Lower respiratory tract infection
