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目的分析心胸外科手术后肺部感染的病原菌分布特点,探讨加强抗感染的护理干预措施对患者术后呼吸功能的改善情况。方法回顾性分析绍兴市立医院进行心胸外科手术治疗的468例患者的临床资料,统计术后肺部感染的发生率及病原菌的分布类型。从中随机抽取120例患者,根据护理干预方式的不同分为对照组62例和干预组58例,对照组患者只给予基础护理,干预组患者则加强抗感染的护理干预。对比两组患者术后呼吸功能的改善情况及肺部感染的发生率。结果 468例患者术后共发生肺部感染42例(8.97%),共培养出病原菌42株。铜绿假单胞菌所占的比例最高(30.95%),白色假丝酵母菌所占的比例最低(2.38%);干预组患者术后动脉氧分压[(98.27±24.57)mmHg]、呼吸频率[(16.19±4.05)次/min]、最大通气量[(71.37±17.84)L]、时间通气量[(2.95±0.74)L/h]及第1秒用力呼气容积[(1.37±0.35)L]明显好于对照组[(89.36±22.34)mmHg,(13.26±3.32)次/min,(52.18±13.05)L,(2.43±0.61)L/h,(1.09±0.28)L];干预组术后肺部感染发生率(2.00%)、肺不张发生率(2.00%)明显少于对照组(12.00%,10.00%),差异均具有统计学意义(P<0.05)。结论心胸外科手术后肺部感染以革兰阴性菌为主,根据病原菌分布特点及药敏试验给予合理的抗菌药物治疗并加强抗感染的护理干预,能明显改善患者术后的呼吸功能,降低肺部感染率的发生,提高预后效果。
Objective To analyze the distribution of pathogenic bacteria in pulmonary infection after cardiothoracic surgery, and to explore the improvement of postoperative respiratory function in patients with anti-infective nursing interventions. Methods The clinical data of 468 patients undergoing cardiothoracic surgery in Shaoxing Municipal Hospital were retrospectively analyzed. The incidence of postoperative pulmonary infection and the distribution of pathogens were analyzed. A total of 120 patients were randomly selected and divided into control group (62 cases) and intervention group (58 cases) according to different nursing interventions. Patients in the control group received basic nursing only, while patients in the intervention group enhanced anti-infective nursing intervention. The improvement of respiratory function and the incidence of pulmonary infection were compared between the two groups. Results 468 patients had pulmonary infection in 42 cases (8.97%) after operation, and 42 pathogenic bacteria were co-cultivated. Pseudomonas aeruginosa accounted for the highest proportion (30.95%), Candida albicans accounted for the lowest proportion (2.38%); intervention group patients postoperative arterial oxygen pressure [(98.27 ± 24.57) mmHg], respiratory rate [(16.19 ± 4.05) beats / min], maximum ventilation [(71.37 ± 17.84) L], duration of ventilation (2.95 ± 0.74) L / h and forced expiratory volume of 1 second L was significantly higher than that of the control group [(89.36 ± 22.34) mmHg, (13.26 ± 3.32) / min, (52.18 ± 13.05) L, (2.43 ± 0.61) L / h, (1.09 ± 0.28) L] The incidence of postoperative pulmonary infection (2.00%) and the incidence of atelectasis (2.00%) were significantly lower than those in the control group (12.00%, 10.00%). The differences were statistically significant (P <0.05). CONCLUSIONS: Gram-negative bacteria are the most common pulmonary infections after cardiothoracic surgery. According to the distribution of pathogenic bacteria and susceptibility testing, rational antimicrobial treatment and anti-infective nursing interventions can significantly improve postoperative respiratory function and lung function Department of infection rate, improve prognosis.