摘要
目的探讨盐酸右美托咪定复合镇痛对烧伤患儿术后感染影响,为降低术后感染提供依据。方法选择2014年1月-2015年8月就诊的700例择期全麻下行大面积烧伤削痂植皮术患儿临床资料,随机数字表法分为对照组和观察组,各350例,对照组采取舒芬太尼2μg/kg+格拉司琼100μg/kg,观察组采用右美托咪定2.5μg/kg+舒芬太尼1.5μg/kg+格拉司琼100μg/kg,全麻手术术毕均给予自控静脉镇痛(PCIA),对比分析两组患儿术后感染率,采用SPSS 19.0软件对数据进行统计分析。结果对照组、观察组烧伤患儿术后感染48、30例,感染率分别为13.71%、8.57%,两组比较差异有统计学意义(χ2=5.250,P<0.05);两组患儿感染部位均以创面、静脉导管、呼吸道为主,其中对照组分别为34、10、5例,分别占61.82%、18.18%、9.09%,合并多部位感染7例,观察组分别为21、8、4例,分别占55.26%、21.05%、10.53%,合并多部位感染8例,两组比较差异无统计学意义;对照组共检出病原菌56株,其中革兰阴性菌、革兰阳性菌、真菌分别为39、15、2株,各占69.64%、26.79%、3.57%;观察组共检出病原菌42株,其中革兰阴性菌、革兰阳性菌、真菌分别为27、14、1株,各占64.29%、33.33%、2.38%。结论盐酸右美托咪定复合术后镇痛可影响小儿烧伤术后感染,降低感染率,小儿烧伤术后感染病原菌种类较多,应依据感染特点积极治疗。
OBJECTIVE To explore the effect of dexmedetomidine compound analgesic on postoperative infections in pediatric burn in order to provide evidence for reducing postoperative infections in pediatric burn.METHODS A total of 700 patients with extensive burns undergoing general anesthesia combined with tangential excision and skin grafting from Jan.2014 to Aug.2015 in our hospital were selected.They were randomly divided into control group and observation group,with 350 cases in each group.Children in the control group received sufentanil 2μg/kg and granisetron 100μg/kg,while children in the observed group were given dexmedetomidine 2.5μg/kg,sufentanil1.5μg/kg,and granisetron 100μg/kg.Patients were given controlled intravenous analgesia（PCIA）after anesthesia surgery.The infection rates were analyzed in two groups,and the results were analyzed by using SPSS software.RESULTS There were respectively 48 and 30cases of burned children infected in the control group and the observation group,with the infection rates of 13.71% and 8.57%,and the difference was significant（χ^2=5.250,P〈0.05）.The main sites of infection were wounds,venous catheters,respiratory tract,with 34,10and5 cases respectively in the control group and 61.82%,18.18% and 9.09% for the constituent ratio accordingly,and 7cases of infection with multiple sites.While in observation group,there were 21,8and 4cases respectively and 55.26%,21.05% and 10.53% for the constituent ratio accordingly,and 8cases of infection with multiple sites.There was no significant difference in two groups.There were 56 pathogens detected in control group,including 39gram-negative bacteria,15gram-positive bacteria and 2fungi with a ratio of 69.64%,26.79% and3.57%,respectively.While there were 42 pathogens detected in observation group,including 27gram-negative bacteria,14gram-positive bacteria and 1fungi with a ratio of 64.29%,33.33% and 2.38%,respectively.CONCLUSION The results show that dexmedetomidine compound analgesic may affect postoperative infections after pediatric burn,which can reduce infection rate.The pathogens are various in postoperative infection of the pediatric burn,so more aggressive treatment should be taken based on infection characteristics.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第5期1149-1151,共3页
Chinese Journal of Nosocomiology
基金
河北省卫生厅重点科技研究计划基金资助项目(20150633)
关键词
右美托咪定
病原菌
患儿
烧伤
感染
Dexmedetomidine
Pathogens
Pediatric burn
Infection
