肝癌行肝切除术后发生肺部感染70例临床护理分析 Clinical Nursing Analysis of 70 Patients Suffering Postoperative Pulmonary Infection after Liver Resection

目的：探寻肝癌行肝切除术后发生肺部感染病人的共同特征和预后转归，为预防和护理术后肺部感染提供帮助。方法：回顾性分析70例肝癌行肝切除术后发生肺部感染病人的临床资料，分析其发生时间、临床表现、治疗方法、护理措施和预后转归。结果：全部70例病人肺部感染都发生在术后15天内，其中59例(84.3%)发生在肝切除术后2~6天之间。最常见的临床表现为发热、胸闷、气促、咳痰，继而出现血氧饱和度下降。70例病人中有58例进行了痰标本的细菌培养，共分离出42例病原菌。病人一经诊断，立即给予抗生素治疗，同时给予持续雾化吸入、协助咳痰。13例病人进行气管插管呼吸机辅助通气。68例经积极治疗后肺部感染获得治愈，2例病人因多器官功能衰竭而死亡。结论：肝切除术后2~6天是肺部感染的高发时期，早期有效抗生素治疗和持续雾化吸入、协助咳痰有助于病人的恢复。 Aim: To investigate the clinical features and prognosis of patients undergoing liver resection who suffer postoperative pulmonary infection, and try to provide some useful nursing measures to prevent such complication. Methods: All the patients undergoing liver resection who suffered postoperative pulmonary were included in the study. The clinical data were collected and analyzed retrospectively, including the occurring time, clinical manifestation, treatment, nursing and prognosis of outcome. Results: A total of 70 patients were enrolled in the study. Pulmonary infection happened within 15 days after operation in all the 70 patients, of which 59 (84.3%) patients suffered pulmonary infection between day 2 and day 6 after operation. The most common clinical features were fever, chest distress, short breath and expectoration. A total of 58 patients received bacterial culture with sputum, of which 42 samples were positive. Treatments included antibiotics, continuous atomization inhalation, expectoration assistance, and tracheal intubation was given in 13 patients. A total of 68 patients recovered completely, while 2 patients died of multiple organ failure. Conclusions: Day 2 to day 6 was the high risk duration of pulmonary infection after liver resection. Early treatment with effective antibiotics, continuous atomization inhalation and expectoration assistance could benefit the recovery.