Effect of oral pretreatment with povidone iodine on oropharyngeal pathogens and lower respiratory tract infection on elderly spinal surgery under general anesthesia

YANG Yu-chun; HU Yu-ping; ZHANG Jia-yong; ZHANG Ying; SUN Fan; TIAN Zhen

doi:10.11659/jjssx.12E022007

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Effect of oral pretreatment with povidone iodine on oropharyngeal pathogens and lower respiratory tract infection on elderly spinal surgery under general anesthesia

Clinical Research | 更新时间：2023-05-26

- Effect of oral pretreatment with povidone iodine on oropharyngeal pathogens and lower respiratory tract infection on elderly spinal surgery under general anesthesia
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 32, Issue 5, Pages: 421-423(2023)
- 作者机构：
  
  1.南京医科大学第四附属医院麻醉科，江苏南京 210031
  2.南京医科大学第四附属医院骨科，江苏南京 210031
  3.南京鼓楼医院集团宿迁医院麻醉科，江苏宿迁 223800
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.12E022007
  CLC： R187;R681
- Published：25 May 2023，
  
  Received：01 December 2022，
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杨玉春,胡玉萍,张加永等.聚维酮碘口腔预处理对全麻下老年脊柱手术患者口咽部病原菌和下呼吸道感染的影响[J].局解手术学杂志,2023,32(05):421-423.

YANG Yu-chun,HU Yu-ping,ZHANG Jia-yong,et al.Effect of oral pretreatment with povidone iodine on oropharyngeal pathogens and lower respiratory tract infection on elderly spinal surgery under general anesthesia[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(05):421-423.
杨玉春,胡玉萍,张加永等.聚维酮碘口腔预处理对全麻下老年脊柱手术患者口咽部病原菌和下呼吸道感染的影响[J].局解手术学杂志,2023,32(05):421-423. DOI： 10.11659/jjssx.12E022007.

YANG Yu-chun,HU Yu-ping,ZHANG Jia-yong,et al.Effect of oral pretreatment with povidone iodine on oropharyngeal pathogens and lower respiratory tract infection on elderly spinal surgery under general anesthesia[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(05):421-423. DOI： 10.11659/jjssx.12E022007.

摘要

目的

探讨0.5%聚维酮碘口腔预处理对气管插管全麻下老年脊柱手术患者口咽部病原菌变化和下呼吸道感染的影响。

方法

选取在气管插管全麻下行脊柱手术的264例患者为研究对象，按照单双数将其分为对照组（麻醉前用0.9%生理盐水口腔清洁预处理）和观察组（麻醉前用0.5%聚维酮碘口腔清洁预处理），每组132例。统计2组患者的手术类型、ASA分级、手术部位、气管插管机械通气时间及手术时间等手术和麻醉情况。手术结束时，取2组患者咽拭子、痰液及导管套囊黏附物进行病原菌培养，统计2组病原菌检出及住院期间下呼吸道感染情况。

结果

2组患者的手术类型、ASA分级、手术部位、气管插管机械通气时间及手术时间等手术和麻醉情况比较差异无统计学意义（

0.05）。364例患者中共57例检出病原菌，其中革兰氏阴性菌38例，革兰氏阳性菌18例，真菌1例。对照组患者咽拭子、痰液、导管套囊黏附物病原菌检出率显著高于观察组，差异均有统计学意义（

0.05）。观察组术后下呼吸道感染率为2.27%，低于对照组的9.85%，差异有统计学意义（

0.05）。

结论

在麻醉前使用0.5%聚维酮碘消毒液口腔预处理，能降低气管插管全麻下老年脊柱手术患者口咽部病原菌检出率，减少下呼吸道感染。

Abstract

Objective

To investigate the effect of oral pretreatment with 0.5% povidone iodine on the pathogenic changes of oropharynx and lower respiratory tract infection in elderly patients undergoing spinal surgery under general anesthesia with endotracheal intubation.

Methods

A total of 264 elderly patients who underwent spinal surgery under general anesthesia with endotracheal intubation were selected and divided into the control group (oral cleaning pretreatment with 0.9% normal saline before anesthesia) and observation group (oral cleaning pretreatment with 0.5% povidone iodine before anesthesia)

with 132 cases in each group according to odd-even number method.The surgery type

American Society of Anesthesiologists (ASA) classification

surgery site

mechanical ventilation time of endotracheal intubation and surgery time of the two groups were counted.At the end of the surgery

the adhesions of throat swabs

sputum and endotracheal tube cuff of the two groups were taken for pathogenic culture

and the pathogenic detection and the infection of lower respiratory tract during hospitalization between the two groups were compared.

Results

There was no significant difference in the surgery type

ASA classification

surgery site

mechanical ventilation time of endotracheal intubation or surgery time between the two groups (

0.05).Among 364 patients

57 cases were found pathogens

including 38 cases of gram-negative bacteria

18 cases of gram-positive bacteria and 1 case of fungus.The pathogenic detection rates of the adhesions of throat swabs

sputum and endotracheal tube cuff in the control group were higher than those in the observation group

with statistically significant differences (

0.05).The postoperative infection rate of lower respiratory tract in the observation group was lower than that in the control group (2.27%

vs.

9.85%)

with statistically significant difference (

0.05).

Conclusion

The oral pretreatment with 0.5% povidone iodine disinfectant before anesthesia can decrease the detection rate of pathogens in elderly spinal surgery under general anesthesia with endotracheal intubation

and reduce the infection of lower respiratory tract.

关键词

聚维酮碘气管插管脊柱手术下呼吸道感染革兰氏阴性菌

Keywords

povidone iodineendotracheal intubationspinal surgerylower respiratory tract infectiongram-negative bacteria

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