腹部手术后院内肺炎的危险因素分析

摘要

目的 探讨腹部手术后导致院内肺炎的危险因素。方法 采用单因素分析法及非条件Logistic逐步回归分析可能导致院内肺炎的18种危险因素。结果 单因素分析表明吸烟史等10项与术后肺炎的发生有关。进一步多元回归分析表明：并存慢性阻塞性肺病（慢阻肺）(OR=17.01)、麻醉方式(OR=16.45)、切口长度(OR=2.25)、手术持续时间(OR=0.90)、术前0.5h预防性应用抗生素(OR=0.38)及机械通气(OR=0.38)是术后院内肺炎的高危因素。结论 患者并存慢阻肺，术前不预防性应用抗生素，手术切口和手术持续时间太长，采用气管插管、机械通气等全麻方式，是术后发生院内肺炎的主要原因。%Objective To investigate risk factors for nosocomial pneumoniafollowing abdominal surgery.Methods 18 risk factors were assessed by single factor analysis and Logistic regression.Results By single factor analyzing on 18 factors, the differences of 10 factors were significant.6 risk factors were identified as independent by logistic regression, including chronic obstructive disease of lung (OR=17.01),anesthetization(OR=16.45),the length of incision (OR=2.25), long time in operation(OR=0.90), administration of preoperative antibiotics (OR=0.38) and mechanical ventilation(OR=0.38).Conclusion 6 of 18 were risk factors resulting in nosocomial pneumonia in abdominal surgical patients.