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外科手术患者术后院内获得性肺炎发生的影响因素

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目的 探讨外科手术患者术后院内获得性肺炎(HAP)发生的相关影响因素。方法 回顾性选择2020年1月至2023年2月在九江市第一人民医院行外科手术治疗的2 824例患者临床资料,按患者术后是否发生HAP分为HAP组(31例)和非HAP组(n=2 793例),分析外科手术患者术后HAP发生的相关影响因素。结果 单因素分析结果提示,不同年龄、手术性质、麻醉方式、合并糖尿病、吸烟史、气管切开、留置胃管、手术时间>3 h与患者术后HAP发生率比较,差异有统计学意义(P<0。05);性别、手术切口类型、术中出血量、合并高血压与外科手术患者术后HAP发生无关,差异无统计学意义(P>0。05);经logistic回归分析显示,年龄≥60岁(β=0。899,OR=2。458,95%CI=1。205~5。011)、急诊手术(β=1。985,OR=7。279,95%CI=3。488~15。188)、全麻(β=2。739,OR=15。464,95%CI=2。106~113。569)、合并糖尿病(β=0。983,OR=2。672,95%CI=1。310~5。450)、吸烟史(β=1。150,OR=3。157,95%CI=1537~6。484)、气管切开(β=1。043,OR=2837,95%CI=1331~6。047)、留置胃管(β=0。753,OR=2。123,95%CI=1。035~4。355)、手术时间>3 h(β=2。198,OR=9。006,95%CI=4。384~18。501)是外科手术患者术后HAP发生的高危因素(P<0。05)。结论 外科手术患者术后易发生HAP,其发生受多种因素共同影响,临床可针对各因素制定相应的防治对策,可减少HAP发生。
Influencing factors on postoperative hospital acquired pneumonia in sur-gical patients
Objective To explore the relevant influencing factors of postoperative hospital acquired pneumonia(HAP)in surgical patients.Methods The clinical data of 2 824 patients undergoing surgical treatment in Jiujiang First People's Hos-pital from January 2020 to February 2023 were retrospectively selected.The patients were divided into HAP group(31 cas-es)and non HAP group(n=2 793 cases)according to whether they had HAP after surgery.Results The results of single fac-tor analysis showed that there were significant differences in the incidence between patients with different age,nature of surgery,mode of anesthesia,diabetes,smoking history,tracheotomy,indwelling gastric tube,and operation time>3 h(P<0.05);Sex,type of Surgical incision,amount of intraoperative bleeding,and hypertension were not related to postoperative HAP in surgical patients,and the difference was not statistically significant(P>0.05);According to logistic regression anal-ysis,age ≥ 60 years old(β=0.899,OR=2.458,95%CI=1.205-5.011),emergency surgery(β=1.985,OR=7.279,95%CI=3.488-15.188),general anesthesia(β=2.739,OR=15.464,95%CI=2.106-113.569),combined with diabetes(β=0.983,OR=2.672,95%CI=1.310-5.450),smoking history([3=1.150,OR=3.157,95%CI=1.537-6.484),tracheotomy(β=1.043,OR=2.837,95%CI=1.331-6.047),indwelling gastric tube(β=0.753,OR=2.123,95%CI=1.035-4.355),surgery time>3 h(β=2.198,OR=9.006,95%CI=4.384-18.501)were high-risk factors for postoperative HAP in surgical patients(P<0.05).Conclusion Surgical patients are prone to postoperative HAP,which is influenced by multiple factors.Corresponding prevention and treatment strategies can be developed for each factor in clinical practice,which may reduce the occurrence of HAP.

Hospital acquired pneumoniaSurgical proceduresSmoking historyTracheotomyIndwelling gastric tube

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江西省九江市第一人民医院感控处,江西九江 332000

院内获得性肺炎 外科手术 吸烟史 气管切开 留置胃管

江西省卫生健康委科技项目

202211768

2024

中国当代医药
中国保健协会 当代创新(北京)医药科学研究院

中国当代医药

影响因子:1.215
ISSN:1674-4721
年,卷(期):2024.31(1)
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