支气管镜检查患者术后发热影响因素分析
|
摘要
目的:调查支气管镜检查患者术后发热的影响因素,为预防术后发热提供依据。方法:于2017年7-12月,调查我院住院行支气管镜检查患者术后发热的情况,采用多元Logistic回归模型分析术后发热的影响因素。结果:500例住院行支气管镜检查患者中80例(16.0%)术后出现了发热;多因素分析结果表明,术前牙菌斑指数、行镜下黏膜活检或肺泡灌洗以及手术时间是患者支气管镜检查术后发热的危险因素。结论 :术前牙菌斑指数越高、行镜下黏膜活检或肺泡灌洗、手术时间越长,术后发热的可能性越大;术前采取有效措施减少牙菌斑、改善患者口腔卫生状况,严格遵守操作指南,缩短操作时间,可以预防术后发热。
Objective: To investigate the influencing factors of postoperative fever after painless bronchoscopy, so as to provide references for the prevention of postoperative fever. Methods: We investigated the postoperative fever of the inpatients with painless bronchoscopy in our hospital from July to December, 2017 and multivariate Logistic regression model was used to analyze the influencing factors of postoperative fever. Results: Totally eighty patients(16.0%) of the 500 inpatients who underwent bronchoscopy developed fever after surgery. The results of multivariate analysis showed that preoperative plaque index, intraoperative biopsy or lavage and operative time were the risk factors of postoperative fever after bronchoscopy.Conclusion: The higher preoperative plaque index, the longer intraoperative biopsy or irrigation, and the longer operative time were, the greater the possibility of postoperative fever was. In order to prevent postoperative fever, it is suggested that we should strictly obey the operation guide, shorten the operative time, and take effective measure before the operation to reduce the plaque to improve the oral hygiene condition of the patient.
Objective: To investigate the influencing factors of postoperative fever after painless bronchoscopy, so as to provide references for the prevention of postoperative fever. Methods: We investigated the postoperative fever of the inpatients with painless bronchoscopy in our hospital from July to December, 2017 and multivariate Logistic regression model was used to analyze the influencing factors of postoperative fever. Results: Totally eighty patients(16.0%) of the 500 inpatients who underwent bronchoscopy developed fever after surgery. The results of multivariate analysis showed that preoperative plaque index, intraoperative biopsy or lavage and operative time were the risk factors of postoperative fever after bronchoscopy.Conclusion: The higher preoperative plaque index, the longer intraoperative biopsy or irrigation, and the longer operative time were, the greater the possibility of postoperative fever was. In order to prevent postoperative fever, it is suggested that we should strictly obey the operation guide, shorten the operative time, and take effective measure before the operation to reduce the plaque to improve the oral hygiene condition of the patient.
引文
[1]Picard E,Schwartz S,Goldberg S,et al.Aprospective study of fever and bacteremia after flexible fiberoptic bronchoscopy in children.Chest,2000,117(2):573-577.
[2]Um SW,Choi CM,Lee CT,et al.Prospective analysis of clinical characteristics and risk factors of postbronchoscopy fever.Chest,2004,125(3):945-952.
[3]邓小梅,谭星雨,王金国,等.纤维支气管镜术后发热的临床特点.中华结核和呼吸杂志,2005,28(12):830-832.Deng XM,Tan XY,Wang JG,et al.A prospective study of clinical characteristics of fever after fiberoptic bronchoscopy.Chin J Tubere Respir Dis,2005,28(12):830-832.
[4]张鹏宇,张国清,谢国刚,等.免疫损害宿主纤维支气管镜术后发热的发生率和相关因素.中国内镜杂志,2009,15(7):677-679.Zhang PY,Zhang GQ,Xie GG,et al.Incidence and factors related to post-bronchoscopy fever in immunocompromised patients.China Journal of Endoscopy,2009,15(7):677-679.
[5]张志强,杨艳荣.支气管镜术后发热36例临床分析.中国煤炭工业医学杂志,2010,13(2):183-184.Zhang ZQ,Yang YR.Clinical analysis of 36 cases with bronchoscope postoperative fever.Chinese Journal of Coal Industry Medicine,2010,13(2):183-184.
[6]张曙光,冯勇,罗纪,等.支气管镜检后发热回顾和前瞻性研究分析.中国内镜杂志,2013,19(2):123-126.Zhang SG,Feng Y,Luo J,et al.A prospective and retrospective study of clinical characteristics of post-bronchoscopy fever.China Journal of Endoscopy,2013,19(2):123-126.
[7]燕玲,李惠萍,周鹏,等.心血管手术患者术前牙菌斑对术后肺部感染的影响.中华护理杂志,2011,46(12):1206.Yan L,Li HP,Zhou P,et al.Effect of preoperative dental plaque on pulmonary infection in patients undergoing cardiovascular surgery.Chinese Journal of Nursing,2011,46(12):1206.
[8]卞金有.预防口腔医学.5版.北京:人民卫生出版社,2008:56.Bian JY.Preventive stomatology.5th ed.Beijing:People's Medical Publishing House,2008:56.
[9]中华医学会呼吸病学分会支气管镜学组.纤维支气管镜(可弯曲支气管镜)临床应用指南(草案).中华结核和呼吸杂志,2000,23(3):134-135.Bronchoscopy Group,Society of Respiratory Diseases,Chinese Medical Association.Guidelines for clinical application of fiberoptic bronchoscope(flexible bronchoscope)(draft).Chinese Journal of Tuberculosis and Respiratory Diseases,2000,23(3):134-135.
[10]钟启平.口腔微生物学.北京:人民卫生出版社,2009:137-141.Zhong QP.Oral microbiology.Beijing:People's Medical Publishing House,2009:137-141.
[11]贾文祥.微生物生物膜研究的新进展.微生物学免疫学进展,2012,40(5):1-9.Jia WX.Progress in microbial biofilm research.Progress in Microbiology and Immunology,2012,40(5):1-9.
[12]Munro Cl,Grap MJ,Jablonski R,et al.Oral health measurement innursing research:state of the science.Biol Res Nurs,2006,8(1):35-42.
[13]李中琴,刘剑渡,李成章,等.牙周维护治疗中牙同隙菌斑控制的方法与效果.中华护理杂志,2009,44(1):30-31.Li ZQ,Liu JD,Li CZ,et al.Effect of interdental plaque control on patients during periodontal maintenance therapy.Chinese Journal of Nursing,2009,44(1):30-31.
[14]李冬梅,李凯,李龙云,等.成人(支)气管镜麻醉的研究进展.中国实验诊断学,2017,21(4):739-742.Li DM,Li K,Li LY,et al.Advances in the study of adult(branch)tracheoscopy anesthesia.Chinese Experimental Diagnostics,2017,21(4):739-742.
[2]Um SW,Choi CM,Lee CT,et al.Prospective analysis of clinical characteristics and risk factors of postbronchoscopy fever.Chest,2004,125(3):945-952.
[3]邓小梅,谭星雨,王金国,等.纤维支气管镜术后发热的临床特点.中华结核和呼吸杂志,2005,28(12):830-832.Deng XM,Tan XY,Wang JG,et al.A prospective study of clinical characteristics of fever after fiberoptic bronchoscopy.Chin J Tubere Respir Dis,2005,28(12):830-832.
[4]张鹏宇,张国清,谢国刚,等.免疫损害宿主纤维支气管镜术后发热的发生率和相关因素.中国内镜杂志,2009,15(7):677-679.Zhang PY,Zhang GQ,Xie GG,et al.Incidence and factors related to post-bronchoscopy fever in immunocompromised patients.China Journal of Endoscopy,2009,15(7):677-679.
[5]张志强,杨艳荣.支气管镜术后发热36例临床分析.中国煤炭工业医学杂志,2010,13(2):183-184.Zhang ZQ,Yang YR.Clinical analysis of 36 cases with bronchoscope postoperative fever.Chinese Journal of Coal Industry Medicine,2010,13(2):183-184.
[6]张曙光,冯勇,罗纪,等.支气管镜检后发热回顾和前瞻性研究分析.中国内镜杂志,2013,19(2):123-126.Zhang SG,Feng Y,Luo J,et al.A prospective and retrospective study of clinical characteristics of post-bronchoscopy fever.China Journal of Endoscopy,2013,19(2):123-126.
[7]燕玲,李惠萍,周鹏,等.心血管手术患者术前牙菌斑对术后肺部感染的影响.中华护理杂志,2011,46(12):1206.Yan L,Li HP,Zhou P,et al.Effect of preoperative dental plaque on pulmonary infection in patients undergoing cardiovascular surgery.Chinese Journal of Nursing,2011,46(12):1206.
[8]卞金有.预防口腔医学.5版.北京:人民卫生出版社,2008:56.Bian JY.Preventive stomatology.5th ed.Beijing:People's Medical Publishing House,2008:56.
[9]中华医学会呼吸病学分会支气管镜学组.纤维支气管镜(可弯曲支气管镜)临床应用指南(草案).中华结核和呼吸杂志,2000,23(3):134-135.Bronchoscopy Group,Society of Respiratory Diseases,Chinese Medical Association.Guidelines for clinical application of fiberoptic bronchoscope(flexible bronchoscope)(draft).Chinese Journal of Tuberculosis and Respiratory Diseases,2000,23(3):134-135.
[10]钟启平.口腔微生物学.北京:人民卫生出版社,2009:137-141.Zhong QP.Oral microbiology.Beijing:People's Medical Publishing House,2009:137-141.
[11]贾文祥.微生物生物膜研究的新进展.微生物学免疫学进展,2012,40(5):1-9.Jia WX.Progress in microbial biofilm research.Progress in Microbiology and Immunology,2012,40(5):1-9.
[12]Munro Cl,Grap MJ,Jablonski R,et al.Oral health measurement innursing research:state of the science.Biol Res Nurs,2006,8(1):35-42.
[13]李中琴,刘剑渡,李成章,等.牙周维护治疗中牙同隙菌斑控制的方法与效果.中华护理杂志,2009,44(1):30-31.Li ZQ,Liu JD,Li CZ,et al.Effect of interdental plaque control on patients during periodontal maintenance therapy.Chinese Journal of Nursing,2009,44(1):30-31.
[14]李冬梅,李凯,李龙云,等.成人(支)气管镜麻醉的研究进展.中国实验诊断学,2017,21(4):739-742.Li DM,Li K,Li LY,et al.Advances in the study of adult(branch)tracheoscopy anesthesia.Chinese Experimental Diagnostics,2017,21(4):739-742.