Objective To investigate the risk factors of nosocomial infections in elderly patients with nonvariceal upper gastrointestinal hemorrhage, and to adopt reasonable protective and therapeutic measures. Methods Sixty-nine cases of nosocomial infection and 141 cases of non-nosocomial infection in elderly inpatients with nonvariceal upper gastrointestinal hemorrhage cases were analyzed by logistic regression analysis retrospectively. Results The incidence of nosocomial infection was 32. 9％. There were significant differences in mini scores, the length of hospital stay, antibiotics application,invasive treatment and underlying diseases between the two groups( P ＜0. 05 ). After logistic regression analysis, nutrition status, physical force, the length of hospital stay and invasive treatment showed positive correlation with nosocomial infection( P ＜ 0.05 ). Nosocomial infections occurred mainly in lower respiratory tract (55. 1％ ), urinary tract infection (40. 6％ ), catheter-related blood stream infection(4. 3％ ) ,and the main pathogenic organism of nosocomial infections was gram negative bacilli ( 64. 6％ ). Conclusions The elderly patients with nonvariceal upper gastrointestinal hemorrhage are vulnerable to nosocomial infections, which are closely related to the patients' nutrition status, physical force, the length of hospital stay,invasive treatment. In order to reduce the rate of nosocomial infection, the risk factors should be payed attention and proper preventive measures should be taken.%目的 探讨老年非静脉曲张性上消化道出血患者并发医院感染发生的危险因素,以利于合理防治.方法 回顾性调查老年非静脉曲张性上消化道出血住院患者210例,对69例并发医院感染病例(感染组)与141例未并发医院感染病例(非感染组)进行logistic回归分析.结果 210例老年患者中,发生院内感染69例,感染率32.9%.患者营养状况、体力状况、住院时间、侵入性操作与发生医院感染呈显著正相关(P＜0.05),与性别、贫血程度无明显相关性.医院感染部位以下呼吸道和泌尿道、导管相关血源性感染为主,分别占55.1%、40.6%和4.3%.菌群组成以革兰阴性杆菌为主,占64.6%.结论 老年上消化道出血患者住院期间易发生医院感染,感染发生与患者营养状况、体力状况、住院时间、侵入性操作有关,应重视危险因素,采取积极应对措施,减少医院感染的发生.
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