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目的探讨新生儿重症监护病房(NICU)医院感染相关的危险因素,研究其预防策略,为降低感染率提供科学依据。方法选择2010-2012年入住NICU救治的6383例新生儿,以是否发生医院感染,各取486例分别作为病例组和对照组,基于logistic回归模型采用SPSS19.0软件进行分析。结果产程延长、低出生体重儿、小于胎龄儿、机械通气、抗菌药物使用>7d、脐静脉置管、使用激素、胃肠外营养、危重程度<70分、反应低下、高胆红素血症、呼吸困难、窒息、羊膜早破、羊水粪染、早产、置胃管、PICC、住院>14d等19个因素为相关危险因素,其中有9个因素是独立高危因素,Waldχ2值>10及Exp(β)值位于前3位的是早产、低出生体重儿和危重度<70分。结论现阶段随着NICU标准化建设,医院感染主要危险因素趋向免疫功能低下的众多原发病,只有降低原发病易感性,才能进一步降低感染发生率。
Objective To investigate the risk factors associated with nosocomial infection in neonatal intensive care unit (NICU) and to study its preventive strategies to provide a scientific basis for reducing the infection rate. Methods 6383 newborns admitted to the NICU between 2010 and 2012 were selected for hospital infection. 486 cases were taken as case group and control group respectively, and analyzed by SPSS19.0 software based on logistic regression model. The results of labor to extend, low birth weight children, less than gestational age children, mechanical ventilation, antimicrobial use> 7d, umbilical vein catheterization, the use of hormones, parenteral nutrition, the severity of <70 points, low response, hyperbilirubinemia 19 factors such as disease, dyspnea, asphyxia, premature amniotic membrane rupture, meconium amniotic fluid, premature delivery, gastric tube placement, PICC and hospitalization> 14 days were related risk factors, of which 9 were independent risk factors, Waldχ2> 10 and The first three digits of the Exp (β) value were premature, low birth weight, and critically ill <70 points. Conclusion With the standardization of NICU at this stage, the main risk factors of nosocomial infection tend to be numerous primary diseases with low immunocompetence, and the incidence of infection can be further reduced only by reducing the susceptibility of the primary disease.