目的 研究导致ICU患者鲍曼不动杆菌定植发生的各项主要因素,并探讨引致ICU患者不动杆菌定植因素对于临床治疗及预防的意义.方法 选取本院2014年1月-2015年1月入住ICU病房的128例患者及2015年2月-2016年2月入住ICU病房的102例不动杆菌定植患者作为本次研究对象;分析并对比各项相关因素与鲍曼不动杆菌定植发生间的关系,评估导致鲍曼不动杆菌定植发生的主要因素;根据导致鲍曼不动杆菌定植的主要因素制定ICU患者鲍曼不动杆菌定植专项医护方案并实施,以2015年2月-2016年2月间实施ICU患者鲍曼不动杆菌定植专项医护方案后的102例ICU不动杆菌定植患者作为实施后组,以2014年1月-2015年1月间128例ICU患者中的96例不动杆菌定植患者作为实施前组,评估两组患者的耐药情况、鲍曼不动杆菌感染发生情况及临床疗效.结果 患者年龄高于60岁的鲍曼不动杆菌定植率显著高于年龄小于60岁者,P<0.01;采取侵入性操作治疗的患者鲍曼不动杆菌定植率显著高于未采取侵入性操作治疗的患者,P<0.01;合并糖尿病及血糖水平偏高的患者中鲍曼不动杆菌定植率显著高于血糖水平正常的患者,P<0.01;入住ICU时间大于10天的患者中鲍曼不动杆菌定植率显著高于入住时间小于10天的患者,P<0.01;实施后组患者的鲍曼不动杆菌感染发生率明显低于实施前组,P<0.05;实施后组患者临床有效率与实施前组无统计学差异性,P>0.05;实施后组二联以上药物使用率明显低于实施前组,P<0.05.结论血糖水平、患者年龄、侵入性操作治疗及ICU住院时间是鲍曼不动杆菌定植发生的主要因素;ICU患者尽早确认鲍曼不动杆菌定植并给予合理治疗,可有效降低细菌感染的发生率,减小细菌的耐药性,使临床用药更加合理准确,对于临床治疗具有重要意义.%Objective To study the main factors that lead to the occurrence of Bauman Acinetobacter in pa-tients of ICU, and to explore the significance of mastering the factors for the clinical treatment and prevention of ICU patients. Methods The study selected 128 cases from January 2014 to January 2015 and 102 cases of Acinetobacter colonization from February 2015 to February 2016 to analyze and compare the related factors of bacterial colonization. According to the main factors leading to Bauman Acinetobacter colonization of ICU patients, the special care scheme was developed and carried out. The 102 patients from February 2015 to February 2016 were taken as the post imple-mentation group, and 96 out of 128 cases from January 2014 to January 2015 were taken as the control group. Their drug resistance, the occurrence of Bauman Acinetobacter colonization and clinical effect were evaluated. Results The Bauman Acinetobacter colonization rate was significantly higher in patients older than 60 than in patients younger than 60 ( P<0. 01 ) , and it was obviously higher in the intervention treatment group than in the non-intervention group (P<0. 01). Those patients complicated with diabetes and blood glucose or longer duration of hospital stay>10d had high level of Bauman Acinetobacter colonization rate (P <0. 01). It was obviously higher in the post implementation group than in the control group (P<0. 05), but there was no significant difference in clinical effec-tive rate between the two groups (P>0. 05). The usage of over two kinds of drugs was significantly lower in the post group than in the control group ( P<0. 05 ) . Conclusion The levels of blood sugar, age of patients, intervention treatment and duration of ICU stay are the main factors of Acinetobacter baumannii bacterial colonization. ICU pa-tients should be confirmed as Acinetobacter colonization and given proper treatment as soon as possible, which can ef-fectively reduce the bacterial infection incidence and bacterial drug resistance. Clinical medication is more accurate and rational, showing important significance for clinical treatment.
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