摘要
目的探讨重症监护室(ICU)气管切开患者呼吸道感染影响因素,为呼吸道感染的防治提供参考。方法选取2017年1月-12月在医院ICU行气管切开术的84例患者,在气管切开后的第3、7、10、14天分别采集患者咽部及下呼吸道分泌物,行细菌培养及观察是否发生呼吸道感染,分析结果。整理分析患者临床资料,分析呼吸道感染率的影响因素。结果 84例行气管切开术的患者,56例患者发生呼吸道感染,感染率为66.67%;共检出病原菌67株,其中革兰阴性菌43株占64.18%,革兰阳性菌24株占35.72%,主要感染病原菌为肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌,分别占23.88%、20.90%、17.91%;非条件多因素Logistic回归分析显示,年龄≥60岁、合并糖尿病、使用糖皮质激素、使用呼吸机、气管切开时间≥7d、GCS评分<8分是ICU气管切开患者呼吸道感染的影响因素(P<0.05)。结论 ICU气管切开患者容易发生呼吸道感染,呼吸道感染是多种因素共同作用的结果,应针对影响因素进行干预,以降低呼吸道感染的发生。
OBJECTIVE To explore the risk factors of respiratory tract infection in tracheotomy patients in intensive care unit(ICU),so as to provide reference for prevention and control of respiratory tract infection. METHODS We selected 84 cases of tracheotomy patients in ICU during Jan. to Dec. 2017. The pharynx and lower respiratory secretions of the tracheotomy patients were collected on day 3, 7, 10 and 14 after tracheotomy, for which bacterial culture was performed and the occurrence of respiratory tract infection was observed. The results were analyzed. The clinical data of the patients were collected and the influencing factors of the respiratory tract infection rate were analyzed. RESULTS Among the 84 tracheotomy patients, 56 cases of respiratory tract infection occurred, and the infection rate was 66.67%. A total of 67 strains of pathogens were isolated, of which 43 were gram-negative bacteria (64.18%) and 24 were gram-positive bacteria (35.72%). The main pathogenic bacteria were Klebsiella pneumoniae , StaphylocGCCus aureus and Pseudomonas aeruginosa , accounting for 23.88%, 20.90% and 17.91% respectively.Non-conditional multivariate logistic regression analysis showed that age of $60 years old,diabetes, use of glucocorticoid, use of ventilator, tracheotomy time of $7d and GCS score of V8 were independent risk factors of respiratory tract infection in tracheotomy patients in ICU(P V0.05). CONCLUSION The incidence of respiratory tract infection is high in tracheotomy patients in ICU,and the infection is the result of many factors. Intervention should be given according to the corresponding influencing factors, in order to reduce the incidence of respiratory infections.
作者
王淑敏
张爱荣
王晓丹
袁斌
王秀霞
杨林
WANG Shu-min;ZHANG Ai-rong;WANG Xiao-dan;YUAN Bin;WANG Xiu-xia;YANG Lin(Shangqiu First People's Hospital, Shangqiu , Henan 476000, China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第7期1000-1002,1023,共4页
Chinese Journal of Nosocomiology
关键词
重症监护室
气管切开术
呼吸道感染
影响因素
Intensive care unit
Tracheotomy
Respiratory tract infection
Risk factors
