目的 探討層流手術室動態空氣菌落數超標的高危因素。 方法 回顧分析2010年3月－2011年11月168臺次特別潔凈層流手術室動態空氣樣品細菌培養結果的資料，依據層流手術室動態環境下空氣樣品是否超過10個菌落形成單位（CFU）/m3將168例空氣樣品細菌培養的資料分別命名為超標組和正常組。超標組有56臺次，正常組有112臺次。將超標組與正常組就有關手術持續的時間、參與手術的醫務人員數量、參觀人數、手術過程中開門的次數、是否為污染手術、手術及麻醉設備是否在手術過程中有搬動、是否為接臺手術、患者術前1 d是否更衣洗澡以及麻醉方式等因素進行分析比較。 結果 層流手術室動態空氣菌落數超標與參觀手術的人數、術中開門次數、手術類型、術中有無設備搬動及患者術前1 d是否進行更衣洗澡等因素有關（P＜0.05），而與手術持續時間、參加手術的人員數量、是否接臺手術及麻醉方式等無關（P＞0.05）。 結論 參觀手術的人數＞3人、術中開門次數＞10次、手術類型為污染手術、術中有設備搬動及患者術前1 d未進行沐浴更衣是層流手術室動態空氣菌落數超標的高危因素。
ObjectiveTo analyze the risk factors of postoperative cognitive dysfunction (POCD) in elderly patients after abdominal surgery. MethodsThe clinical data of 2 286 patients over 60 years old after abdominal surgery were retrospectively analyzed, which were divided into non-POCD group with 2 248 patients and POCD group with 38 patients. The influencing factors of POCD in elderly patients after abdominal surgery, including the age, gender, anesthetic way, the premedication, cormobided with lung or heart disease, diabetes, jaundice, anemia or hypoproteinemia, the duration of surgery, and postoperative analgesia protocols, were analyzed between two groups. ResultsThe age, anesthetic way, cormobided with lung or heart disease, diabetes, jaundice, with or without continuous postoperative effective analgesia, and surgery duration over four hours were relevant with POCD (Plt;0.05), while gender, the premedication, and preexisted anemia or hypoproteinemia were not relevant with that (Pgt;0.05). ConclusionAge over 70 years, general anaesthesia, cormobided with lung or heart disease, diabetes, jaundice, surgery duration over four hours, and incomplete postoperative analgesia are the risk factors of POCD after abdominal surgery.
【摘要】 目的 探討腹部非胃、十二指腸手術后胃癱綜合征（postoperative gastroparesis syndrome，PGS）發生的高危因素。 方法 回顧分析2004年9月-2010年3月2 559例腹部非胃、十二指腸術后患者的臨床資料，將患者分為PGS組和非PGS組，其中PGS組23例，非PGS組2 536例。 結果 比較PGS組和非PGS組間年齡、性別、術后開始進食時間、手術持續時間、是否為腫瘤晚期、有無貧血低蛋白血癥、既往有無腹部手術史、術后早期有無營養支持等因素，χ2值分別為:19.687、0.018、0.346、48.243、21.801、16.803、24.679、0.870，P值分別是:lt;0.01、gt;0.05、gt;0.05、lt;0.01、lt;0.01、lt;0.01、lt;0.01、gt;0.05。 結論 年齡gt;65歲、手術持續時間gt;4 h、腫瘤晚期、既往有腹部手術史及貧血低蛋白血癥是腹部非胃、十二指腸手術后PGS發生的高危因素。【Abstract】 Objective To analyze the risk factors of postoperative gastroparesis syndrome (PGS) after non-gastroduodenal abdominal surgery. Methods We retrospectively analyzed the clinical data of 2 559 patients who underwent non-gastroduodenal abdominal surgeries in our hospital between September 2004 and March 2010. We divided them into the PGS group with 23 patients and the non-PGS group with 2 536 patients. Results By comparing the age, the gender, the starting time of eating after surgery, the duration of surgery, whether the patients had advanced cancer, whether anemia or hypoproteinemia existed, whether the patients had a history of previous abdominal surgery, and whether nutritional support was provided early after operation between the PGS group and the non-PGS group, we found that the chi-square value was 19.687, 0.018, 0.346, 48.243, 21.801, 16.803, 24.679, 0.870 and the P value waslt;0.01, gt;0.05, gt;0.05, lt;0.01, lt;0.01, lt;0.01, lt;0.01, gt;0.05 respectively. Conclusion Over 65 years of age, the duration of surgery over four hours, advanced cancer, the history of previous abdominal surgery and anemia or hypoproteinemia are the risk factors of PGS after non-gastroduodenal abdominal surgery.