神经内科住院患者医院感染的危险因素及防护措施

摘要

目的:了解神经内科住院患者医院感染发生状况,分析致感染的危险因素,为探讨预防控制措施提供参考依据.方法:回顾性分析神经内科3707例患者临床资料,分析确诊为感染患者的感染率、感染部位、病原菌分布,以及医院感染的危险因素,采用SPSS19.0软件对数据进行统计分析.结果:3707例患者发生医院感染193例,感染率为5.21％;感染患者以下呼吸道感染为主,占55.56％,其次为泌尿道感染占21.74％、上呼吸道感染占12.56％;年龄≥65岁、男性、合并基础疾病、接受侵入性操作、一季度、四季度、无意识状态、糖皮质激素使用、广谱抗菌药物使用及住院时间≥21 d的患者医院感染发生率明显高,是引起医院感染的主要危险因素;共检出致病菌211株,其中多重耐药菌126株占59.72％;革兰阴性杆菌141株占66.82％,革兰阳性菌50株占23.70％,真菌20株占9.48％.结论:神经内科患者医院感染发病率较高,导致医院感染的危险因素多,临床中应综合预防控制,提高整体预防控制效果.%Objective:To investigate the prevalence of nosocomial infections in hospitalized patients of neurology department and analyze the risk factors for infections so as to provide guidance for prevention and control of the infections.Methods:The clinical data of 3707 elderly patients in neurological department of internal medicine were retrospectively analyzed.The infection rates,infection sites,and distribution of pathogens of the patients with confirmed nosocomial infections were observed,the risk factors for the nosocomial infections were analyzed,and the statistical analysis of data was performed with the use of SPSS19.0 software.Results:Of 3707 patients,193 patients had the nosocomial infections with the infection rate of 5.21％,of whom 55.56％ had lower respiratory tract infections,21.74％ had urinary tract infections,and 12.56％ had upper respiratory tract infections.The more than 65 years of age,male,combination of underlying disease,invasive operation,the first quarter and the four quarter,use of corticosteroid or broad-spectrum antibiotics,unconsciousness,hospitalization duration more than 21 days were the main risk factors for the nosocomial infections.Totally 211 strains of pathogens were isolated,including 126(59.72％) strains of multiple resistant bacteria,141 (66.82％)strains of gram-negative bacteria,50 (23.70％) strains of gram-positive bacteria,and 4(9.48％) strains of fungi.Conclusion:The incidence rate of nosocomial infections is high in the elderly patients of the neurological department of internal medicine,there are many risk factors leading to the nosocomial infections.It is necessary for the hospital to take comprehensive prevention measures so as to improve the overall preventive and control effect.