本文關鍵詞： 氣管內插管 喉罩麻醉 兒童 下呼吸道感染 影響　出處：《中華醫(yī)院感染學雜志》2017年17期 　論文類型：期刊論文

【摘要】：目的探究氣管內插管和喉罩麻醉兩種氣道管理方式對手術兒童發(fā)生下呼吸道感染的影響。方法選取2014年1月-2016年1月于醫(yī)院擇期進行手術的106例患兒為研究對象,分析氣管內插管和喉罩麻醉后感染情況;將患兒按照隨機數(shù)表法進行分組,每組各53例;對照組患兒置入氣管內插管,觀察組患兒置入喉罩;術后3d比較兩組患兒中咳嗽、發(fā)熱、肺部聞及粗濕Up音發(fā)生情況;術后10min觀察并統(tǒng)計兩組患兒中恢復自主呼吸的患兒數(shù)量及比例,術后20min統(tǒng)計兩組患兒中拔管患兒數(shù)量及比例;統(tǒng)計氣管內插管和喉罩麻醉后下呼吸道感染發(fā)生情況;采集感染患兒臨床樣本進行病原菌培養(yǎng)及鑒定。結果術后3d對照組咳嗽5例(9.43%)、發(fā)熱9例(16.98%)、肺部聞及粗濕Up音6例(11.32%);觀察組咳嗽1例(1.89%)、發(fā)熱3例(5.66%)、肺部聞及粗濕Up音2例(3.77%),兩組比較差異有統(tǒng)計學意義(P0.05);10min后恢復自主呼吸患兒數(shù)量及比例為對照組45例(84.91%),觀察組48例(90.57%);20min后拔管患兒數(shù)量及比例為對照組24例(45.29%)、觀察組23例(43.40%),兩組比較差異無統(tǒng)計學意義;106例患兒中共有23例發(fā)生下呼吸道感染,感染率為21.70%;其中對照組15例(28.30%),觀察組8例(15.09%),兩組比較差異有統(tǒng)計學意義(P0.05);共檢出病原菌45株,其中革蘭陰性菌34株占75.56%,革蘭陽性菌7株占15.55%,感染病原菌以銅綠假單胞菌、肺炎克雷伯菌、鮑氏不動桿菌為主,分別占31.11%、20.00%、13.33%。結論氣管內插管和喉罩麻醉兩種氣道管理方式均會引起一定的下呼吸道感染,且氣管內插管引起的下呼吸道感染率高于喉罩。
[Abstract]:Objective to investigate the effect of endotracheal intubation and laryngeal mask anesthesia on lower respiratory tract infection in children undergoing operation. The infection after endotracheal intubation and laryngeal mask anesthesia was analyzed. The children were divided into three groups according to random number method: 53 cases in each group; 53 cases in the control group were placed in endotracheal intubation and larynx mask was placed in the observation group; 3 days after operation, cough was compared between the two groups. The number and proportion of spontaneous respiration in the two groups were observed and counted 10 minutes after operation, and 20 minutes after operation, the number and proportion of extubation in the two groups were counted. The incidence of lower respiratory tract infection after endotracheal intubation and laryngeal mask anesthesia was analyzed. Results three days after operation, 5 cases of cough, 9 cases of fever and 16. 98% of cough in the control group, 6 cases of the lung smell and crude wet up sound, 6 cases of the observation group, 1 case of cough 1.89%, 3 cases of fever 5.66%, the lung smell and coarse wet up, the observation group 1 case of cough, 3 cases of fever 5. 66%, the lung smell and the coarse wet up, the observation group 1 case of cough, 3 cases of fever 5.66%, the lung smell and coarse wet up. There were significant differences between the two groups in the number and proportion of children with spontaneous respiration in the control group (45 cases), in the observation group (48 cases) after 20 minutes, in the control group (24 cases), in the control group (24 cases), in the observation group (23 cases), in the control group (23 cases), in the comparison of the two groups. There were 23 cases of lower respiratory tract infection in 106 cases. The infection rate was 21.70 in the control group (15 cases) and the observation group (8 cases), the difference between the two groups was statistically significant (P 0.05). A total of 45 strains of pathogenic bacteria were detected, of which 34 strains were Gram-negative bacteria (34 strains), 7 strains were gram-positive bacteria (15.55%), and the pathogenic bacteria were Pseudomonas aeruginosa (Pseudomonas aeruginosa). Klebsiella pneumoniae and Acinetobacter baumannii accounted for 31.11% 20.00% 13.33% respectively. Conclusion endotracheal intubation and laryngeal mask anesthesia can cause lower respiratory tract infection, and the infection rate of lower respiratory tract caused by endotracheal intubation is higher than that caused by laryngeal mask.
【作者單位】： �？谑袐D幼保健院麻醉科;
【基金】：海南省自然科學基金資助項目(20158312)
【分類號】：R726.1

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