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[目的]探讨目标性监测在重症监护病房(ICU)的实施效果,为制定医院感染预防控制措施提供科学依据。[方法]对2009年1月～2010年12月入住ICU的患者进行目标性监测,用患者平均病情严重程度(ASIS)调整法调整医院感染发病率,重点对3种导管留置患者的医院感染发生率进行研究分析。[结果]共监测住院病人415人次,发生医院178例次(42.89%);与同期平均医院例次感染率3.26%(982/30082)相比,差异有统计学意义(P﹤0.005);日医院感染例次率为39.88‰,经ASIS法调整后日医院感染例次率为10.20‰;2009、2010年日例次医院感染率分别为48.47‰、32.23‰,2010年较2009年下降了16.24‰;留置导尿管、动静脉插管、使用呼吸机相关性导管感染例次率分别为(10.32‰、8.63‰)、(9.34‰、6.32‰)、(33.62‰、24.35‰),分别下降了1.69‰、3.02‰、9.27‰;医院感染以呼吸机相关性肺炎为主。[结论]ICU患者是医院感染的高危人群,医院感染以3种导管留置患者为主,目标性监测针对侵入性诊疗操作感染危险因素实施全程管理,重点干预诊疗操作中的医疗行为,可降低医院感染的发生率。
[Objective] To explore the effect of targeted monitoring in intensive care unit (ICU) and provide a scientific basis for the development of hospital infection prevention and control measures. [Methods] The patients in ICU from January 2009 to December 2010 were monitored for the target, and the incidence of nosocomial infections was adjusted by adjusting the patients’ mean severity of illness (ASIS). The focus was on the nosocomial infection in 3 kinds of catheter indwelling patients Rate of research and analysis. [Results] A total of 415 inpatients were monitored and 178 cases were hospitalized (42.89%). Compared with the average hospital infection rate of 3.26% (982/30082) in the same period, the difference was statistically significant (P <0.005) The rate of nosocomial infections was 39.88 ‰, and the number of nosocomial infections was adjusted to 10.20 ‰ after ASIS adjustment. The nosocomial infection rates were 48.47 ‰ and 32.23 ‰ respectively in 2009 and 2010, and decreased by 16.24 in 2010 (10.32 ‰, 8.63 ‰), (9.34 ‰, 6.32 ‰), (33.62 ‰, 24.35 ‰), respectively, decreased in indwelling catheter and arteriovenous catheter, respectively A 1.69 ‰, 3.02 ‰, 9.27 ‰; nosocomial infection mainly ventilator-associated pneumonia. [Conclusion] The ICU patients are the high risk of nosocomial infection. The hospital infection is dominated by three kinds of catheter indwelling patients. The target monitoring is to manage the risk factors of the invasive diagnosis and treatment operation, and focus on the medical behaviors in the diagnosis and treatment operations, which can reduce the hospital The incidence of infection.