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目的探讨重症监护病房医院感染及其相关影响因素。方法采用回顾性调查研究方法,对2012年12月-2014年1月湖州市第一人民医院重症监护病房的786例住院患者进行了医院感染调查分析。结果重症监护病房患者医院感染率为11.32%,感染部位主要是下呼吸道,其次是泌尿道和消化道。重症监护病房医院感染相关因素的单因素分析发现年龄、住ICU时间、机械通气、单纯气管切开、留置导尿、肠内营养、中心静脉置管、应用化疗药物、激素或免疫抑制剂、抗生素使用种类多、抗生素使用天数、手术创口构成不同,医院感染率差异均有统计学意义(均P<0.05),未发现性别不同(P>0.05)。多因素分析发现年龄>50岁、住ICU时间≥5 d、机械通气、单纯气管切开、留置导尿、应用化疗药物、激素或免疫抑制剂、抗生素使用种类1种及以上均为发生医院感染的危险因素(OR=3.281、2.731、12.456、2.182、6.575、2.234、2.042、1.712,均P<0.05)。结论重症监护病房医院感染发生率较高,根据危险因素制订防治对策,可以降低医院感染率。
Objective To investigate the nosocomial infection and its related factors in intensive care unit. Methods A retrospective study was conducted to investigate the prevalence of nosocomial infection in 786 hospitalized patients in the First People’s Hospital of Huzhou from December 2012 to January 2014. Results The nosocomial infection rate was 11.32% in intensive care unit patients. The main infection sites were lower respiratory tract, followed by urinary tract and digestive tract. Univariate analysis of the factors associated with nosocomial infection in the ICU found that age, ICU duration, mechanical ventilation, tracheotomy alone, catheterization, enteral nutrition, central venous catheterization, chemotherapeutic drugs, hormones or immunosuppressants, antibiotics There were no significant differences in sex and age (P> 0.05). There was a significant difference in the types of antibiotics used, the number of antibiotics used, the composition of surgical wounds, and hospital infection rates. Multivariate analysis showed that nosocomial infections occurred in 1 or more types of antibiotics when patients were aged> 50 years, ICU time≥5 days, mechanical ventilation, tracheotomy alone, indwelling catheterization, chemotherapeutic drugs, hormones or immunosuppressants Risk factors (OR = 3.281,2.731,12.456,2.182,6.575,2.234,2.042,1.712, all P <0.05). Conclusion The incidence of nosocomial infection in intensive care unit is high. Based on the risk factors, prevention and cure measures can be formulated to reduce the nosocomial infection rate.