Page 20 - 麻醉与监护论坛2016年第4期

刘江梅1 丁彬1 徐永华2 郑君1 摘要
张安美1
目的:探讨术前鼻腔干预措施对气管插管全身麻醉手术患者后下呼吸
1.潍坊市人民医院麻醉科 道感染的预防效果，为预防患者术后下呼吸道感染提供依据。方法:2013
2，放疗科，山东潍坊 261041 年6月-2015年6月行气管插管全身麻醉择期手术治疗的920例患者为研究对
象，采用随机数字表法将患者随机分为观察组和对照组，每组各460例；
对照组患者给予常规术前准备，干预组在对照组基础上给予35～38℃温生
理盐水进行悬挂式鼻腔冲洗，0.1%聚维酮碘行鼻腔消毒等鼻腔干预措施，
观察组两组患者术后下呼吸道感染的发生率和病原菌分布。结果:观察组
患者下呼吸道感染率为4.57%，显著低于对照组的7.83%差异有统计学意义
(x2=4.208,P<0.05)；观察组21例下呼吸道感染患者检测出病原菌25株，
对照组36例下呼吸道感染者检测出病原菌49株，两组均以肺炎克雷伯菌
及金黄色葡萄球菌为主要病原菌；观察组下呼吸道感染患者的平均住院
天数、住院费用显著低于对照组下呼吸道感染者，差异均有统计学意义
(P<0.05)。结论:术前给予经鼻气管插管全身麻醉手术患者鼻腔冲洗及消毒
等干预措施，可以有效预防术后下呼吸道感染的发生。

关键词：鼻腔；干预措施；下呼吸道感染；气管插管

术前鼻腔干预对经鼻气管插管全身麻醉患

者术后预防下呼吸道感染的评价

Evaluation of prevention effect of preoperative nasal intervention
program on lower respiratory tract infections in patients treated
with general anesthesia by nasal intubation

LIU Jiang-mei,DING Bin,XU Yong-hua,ZHENG Jun,ZHANG An-mei

Weifang People’s Hospital of Shan dong Province,Weifang,Shandong 261041,China

Abstract

Objective. To evaluate the prevention effect of preoperative nasal intervention program on low respiratory tract
infections in patients treated with general anesthesia by nasal intubation,so as to provide the basis for the prevention of
postoperative lower respiratory tract infections.

Methods. Totally 920 patients with endotracheal intubation general anesthesia for selective surgery from jun.2013
to jun.2015 our hospital were selected for the study.Patients were randomly divided into the observation group and
the control group by random number table,460 cases in each group.The control group received routine preoperative
preparation.The intervention group was given warn saline(35-38℃)for suspended nasal irrigation and 0.1% povidone-
iodine to disinfect nasal on basis of treatment in the control group.The incidence of lower respiratory tract infection and
clinical symptoms were observed and pathogen distribution was analyzed for the two groups.

Results. The incidence of lower respiratory tract infection was 4.57% in the observation group,significantly lower than
7.83% in the control group(x2=4.208,P<0.05).Totally 25 pathogens were detected in 21 cases with lower respiratory tract
infection in the observation group,and 49 pathogens were detected in 36 patients with lower respiratory tract infection in
the control group.Klebsiella pneumoniae and Staphylococcus aureus were the main pathogens in both groups.The average
length of stay and hospitalization costs of patients with lower respiratory tract infection were significantly lower in the
observation group than in the control group(P<0.05).

Conclusion. Preoperative nasal interventions such as nasal irrigation and disinfection can be effective in preventing
lower respiratory tract infection in general anesthesia patients with nasotracheal intubation.

Key Words. Nasal cavity;Interventions;Lower respiratory tract infection;Tracheal intubation

Laboratory RanevdieCwlinaincdalCInMvEesLteigcatutiroen 4650 FAM 2016 Jan/Feb Vol.23 Issue 1
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