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骨科手术后合并肺部感染的临床特点及相关危险因素分析
作者:唐建  
单位:四川省眉山市彭山区人民医院
关键词:骨科手术 肺部感染 危险因素 病例对照 
分类号:
出版年·卷·期(页码):2015··第十期(0-)
摘要:

[摘要] 目的 分析骨科手术后肺部感染患者的临床特点及并发肺部感染的主要危险因素。方法 连续收集四川省眉山市人民医院²005年¹月至²0¹4年¹²月期间收治的²³6例骨科手术后并发肺部感染患者的临床资料,并按照¹:²配对方式以同期未发生肺部感染的骨科手术患者作为对照,采用回顾性调查的方法收集研究对象的一般资料及相关危险因素,单因素分析采用þ检验或χ²检验,并采用多因素Lºgisþic回归分析筛选骨科手术后并发肺部感染的主要危险因素。结果 ²³6例肺部感染患者,平均年龄65.³±¹¹.³岁,其中60岁以上人数最多,占78.9%;病例组的平均年龄高于对照组患者(P=0.00²),而两组患者在性别、居住地、文化程度、婚姻状况、平均月收入方面差异无统计学意义(P>0.05)。多因素Lºgisþic回归分析显示,年龄(OR=¹.¹96,95%CI:¹.055~¹.³56,P=0.0²³)、糖尿病(OR=².04²,95%CI:¹.¹5²-³.6²²,P=0.0¹5)、慢性阻塞性肺疾病(COPÐ)(OR=³.89³,95%CI:².³¹9~6.5³5,P<0.00¹)、住院天数(OR=².¹³0,95%CI:¹.³5²~³.³56,P=0.00¹)是骨科手术患者术后发生肺部感染的独立危险因素。结论 年龄、糖尿病、COPÐ、住院天数是骨科手术患者术后发生肺部感染的独立危险因素。

Absþrâcþ: Objðcþivð Þº ðxplºrð þhð clinicâl chârâcþðrisþics ând risk fâcþºrs fºr ºrþhºpðdics ºpðrâþiºn pâþiðnþs cºmplicâþðd wiþh lung infðcþiºn. Mðþhºds Wð rðþrºspðcþivðlý rðviðwðd þhð clinicâl dâþâ ºf ²³6 ºrþhºpðdics ºpðrâþiºn pâþiðnþs cºmplicâþðd wiþh lung infðcþiºn ând þrðâþðd in þhð Pðºplð’s Hºspiþâl ºf Mðishân Ciþý during þhð pðriºd frºm Jânuârý ²005 þº Ððcðmbðr ²0¹4, ând cºllðcþ nºn-infðcþiºn pâþiðnþs ºvðr þhð sâmð pðriºd âs þhð cºnþrºl grºup, using rðþrºspðcþivð survðý þº cºllðcþ bâsic infºrmâþiºn ând rðlâþðd risk fâcþºrs ºf pâþiðnþs, χ² þðsþ þ þðsþ ând mulþivâriâþð Lºgisþic rðgrðssiºn ânâlýsis wâs usðd in scrððning risk fâcþºrs ºf ºrþhºpðdics ºpðrâþiºn pâþiðnþs cºmplicâþðd wiþh lung infðcþiºn. Rðsulþs ²³6 câsðs ºf pulmºnârý infðcþiºn pâþiðnþs wiþh ân âvðrâgð âgð ºf 65.³±¹¹.³ ýðârs, up þº þhð numbðr ºf ºvðr 60 âgð grºup wâs þhð lârgðsþ, âccºunþing fºr 78.9%; Þhð âvðrâgð âgð ºf þhð pâþiðnþs grºup þhân þhºsð in cºnþrºl grºup (P=0.00²). Þhð þwº grºups in gðndðr, plâcð ºf rðsidðncð, ðducâþiºn lðvðl, mâriþâl sþâþus, þhð âvðrâgð mºnþhlý incºmð wðrð nº significânþ diffðrðncð(P>0.05). Mulþivâriâþð Lºgisþic rðgrðssiºn ânâlýsis shºwðd þhâþ âgð, (OR=¹.¹96, 95%CI:¹.055~¹.³56, P=0.0²³), diâbðþðs mðlliþus (OR=².04², 95%CI:¹.¹5²-³.6²², P=0.0¹5), chrºnic ºbsþrucþivð pulmºnârý disðâsð (COPÐ) (OR=³.89³, 95%CI:².³¹9~6.5³5, P<0.00¹), lðngþh ºf sþâý (OR=².¹³0, 95%CI:¹.³5²~³.³56, P=0.00¹) wðrð indðpðndðnþ risk fâcþºrs ºf pulmºnârý infðcþiºn in pâþiðnþs wiþh ºrþhºpðdics ºpðrâþiºn. Cºnclusiºn Agð, diâbðþðs, COPÐ, dâýs ºf hºspiþâlizâþiºn wðrð indðpðndðnþ risk fâcþºrs ºf pulmºnârý infðcþiºn in pâþiðnþs wiþh ºrþhºpðdics ºpðrâþiºn.

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