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目的 研究手术相关医院内肺炎的危险因素。方法 采用病例对照研究的方法回顾性调查手术科室的医院内肺炎病例 ,Logistic回归分析其危险因素。结果 单因素分析发现下列因素与医院内肺炎的发生显著相关 :男性、年龄 6 0岁以上、入住ICU、全身免疫抑制 /严重疾病、气管 /气切插管且在 12小时以上、机械通气且时间超过 48小时、应用湿化系统、2月内曾有手术史、术中发生休克、留置导尿管、意识障碍、使用抗生素种类大于 3种且超过 3天、制酸剂 /H2 受体阻滞剂应用及使用时间超过 3天、手术时间超过 2小时、外科基础疾病为最终致死性疾病和快速致死性疾病、上腹部手术、全麻以及留置鼻胃管且留置时间超过 6小时。Logistic回归分析与肺炎发生高度相关的危险因素为 :高龄、留置鼻胃管超过 6小时、预防性抗生素和制酸剂 /H2 受体阻滞剂的应用以及有全身免疫抑制及严重的基础疾病。结论 高龄、留置鼻胃管、预防性抗生素和制酸剂 /H2 受体阻滞剂的应用 ,全身免疫抑制或严重的基础疾病可能为手术相关的医院内肺炎的高危因素
Objective To study the risk factors of pneumonia in surgery-related hospitals. Methods A case-control study was conducted to retrospectively investigate the pneumonia cases in the surgical department and logistic regression analysis was used to analyze the risk factors. Results Univariate analysis found that the following factors were significantly associated with pneumonia in the hospital: men, over 60 years of age, admitted to the ICU, systemic immunosuppression / serious illness, intubation of the trachea / pneumoperitoneum over 12 hours, mechanical ventilation and time More than 48 hours, the application of humidification system, there was a history of surgery in February, intraoperative shock, indwelling catheter, disturbance of consciousness, the use of antibiotics more than 3 species and more than 3 days, antacid / H2 receptor block Application and use of agents for more than 3 days, operation time more than 2 hours, the basic surgical diseases are the ultimate lethal disease and rapid fatal disease, abdominal surgery, general anesthesia and indwelling nasogastric tube and retention time of more than 6 hours. Logistic regression analysis of the risk factors associated with pneumonia were advanced age, indwelling nasogastric tube for more than 6 hours, the use of prophylactic antibiotics and antacids / H2 blockers as well as systemic immunosuppression and severe underlying diseases. Conclusions The application of advanced age, indwelling nasogastric tube, prophylactic antibiotics and antacid / H2 receptor blocker may lead to systemic risk factors of pneumonia in surgery-related hospitals