摘要
目的探讨高龄患者全髋关节置换术后肺部感染的干预效果,为降低临床感染率提供依据。方法分析2013年4月-2015年1月126例于医院行全髋关节置换术70岁以上患者临床资料,通过单因素和多因素logistic非条件回归分析方法,对影响高龄全髋关节置换术后患者肺部感染的危险因素进行总结,针对引发肺部感染的危险因素进行有效护理,分析临床护理的临床疗效。结果 126例全髋关节置换术患者术后有35例患者发生肺部感染,感染率为27.78%;分离病原菌39株,检出金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌及其他病原菌,分别占35.90%、28.21%、15.38%、7.69%及12.82%;患者年龄、手术时间、使用激素、合并基础疾病、引流时间及住院时间均为影响患者感染的相关因素,差异有统计学意义(P<0.05),对相关危险因素进行多因素logistic回归分析显示,全髋置换术患者年龄≥80岁、并发基础疾病、长期使用激素、手术时间≥160min、引流时间≥2d、住院时间≥30d为患者术后肺部感染的独立危险因素,差异有统计学意义(P<0.05)。结论分析高龄行全髋置换术患者术后肺部感染危险因素对临床护理有一定指导意义,可对患者进行针对性护理,从而有效降低术后肺部感染率。
OBJECTIVE To explore the effect of interventions to postoperative pulmonary infections in elderly patients undergoing total hip arthroplasty so as to reduce the incidence of clinical infections.METHODS A total of 126 patients who underwent the total hip arthroplasty in the hospital from Apr 2013 to Jan 2015 were enrolled in the study,then the clinical data of the patients aged more than 70 years old were analyzed,the univariate analysis and non-conditional multivariate logistic regression analysis were performed for the risk factors for postoperative pulmonary infections in the elderly patients undergoing the total hip arthroplasty,the effective nursing interventions were taken based on the risk factors for the pulmonary infections,and the clinical effects of the clinical nursing interventions were analyzed.RESULTS Of the 126 patients who underwent the total hip arthroplasty,35 had postoperative pulmonary infections,with the infection rate 27.78%.Totally 39 strains of pathogens were isolated,of which 35.90% were Staphylococcus aureus,28.21% were Escherichia coli,15.38% were Klebsiella pneumoniae,7.69% were Pseudomonas aeruginosa,and 12.82% were other species of pathogens.The influencing factors for the infections included the age,operation duration,use of hormones,complication of underlying diseases,drainage time,and length of hospital stay,with statistical significance（P〈0.05）.The multivariate logistic regression analysis of the related risk factors indicated that the independent risk factors for the postoperative pulmonary infections included the no less than 80 years of age,complication of underlying diseases,long-term use of hormones,operation duration no less than 160 min,drainage time no less than 2days,and length of hospital stay no less than 30 days,with statistical significance（P〈0.05）.CONCLUSIONIt is of certain guiding significance to clinical nursing to analyze the risk factors for the postoperative pulmonary infections in the elderly patients undergoing the total hip arthroplasty,and the targeted nursing interventions should be taken so as to effectively reduce the incidence of the postoperative pulmonary infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第10期2317-2319,共3页
Chinese Journal of Nosocomiology
基金
浙江省自然科学基金资助项目(LY13H060005)
关键词
高龄患者
全髋关节置换术
肺部感染
护理干预
Elderly patient
Total hip arthroplasty
Pulmonary infection
Nursing intervention
