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目的通过对急诊科重症患者临床资料进行分析,旨在明确导致急诊科重症患者发生医院感染的危险因素,为针对性进行预防提供依据。方法本研究选取2014年1月—2016年6月浙江省恩泽医疗中心路桥医院急诊科收治的重症患者730例为研究对象,对发生医院感染的部位及相关危险因素进行分析。结果 730例重症患者中,共发生医院感染104例,医院感染的发生率为14.25%,下呼吸道、胃肠道及泌尿系统是医院感染好发的最常见部位;2组患者在年龄、体质指数(BMI)、气管插管或气管切开人数、机械通气时间、深静脉置管人数、留置导尿管人数、抗生素使用≥3种人数、病房每天消毒次数及护士每天监护次数等方面的差异有统计学意义(P<0.05);Logistic回归分析发现:年龄>60岁、BMI>24 kg/m~2、气管插管或气管切开、机械通气时间≥2 d、深静脉置管、留置导尿管、抗生素使用≥3种等是重症患者医院感染发生的危险因素(OR>1,P<0.05),而病房每天消毒次数≥2次及护士每天监护次数≥2次等是避免重症患者医院感染发生的保护性因素(OR<1,P<0.05)。结论急诊科重症患者发生医院感染的危险因素较多,应引起我们的重视,及早进行干预进而减少其医院感染的发生率。
Objective To analyze the clinical data of critically ill patients in emergency department so as to identify the risk factors of nosocomial infection in critically ill patients in emergency department and provide the basis for prevention. Methods A total of 730 critically ill patients admitted to Emergency Department of Luqiao Hospital, Enze Medical Center, Zhejiang Province, China from January 2014 to June 2016 were selected as the research object to analyze the nosocomial infection site and related risk factors. Results Among the 730 critically ill patients, there were 104 cases of nosocomial infection and 14.25% of nosocomial infections. The lower respiratory tract, gastrointestinal tract and urinary system were the most common sites of nosocomial infection. The age, body mass index (BMI), the number of endotracheal intubation or tracheotomy, the duration of mechanical ventilation, the number of deep vein catheterization, the number of indwelling catheters, the number of antibiotics used ≥3, the number of disinfected wards per day and the number of nurses per day (P <0.05). Logistic regression analysis showed that when the age was 60 years old, BMI> 24 kg / m ~ 2, tracheal intubation or tracheotomy, mechanical ventilation time≥2 d, deep vein catheterization and indwelling guide The incidence of nosocomial infections in critically ill patients (OR> 1, P <0.05), and the number of catheter and antibiotic use ≥3 were more than 2 times per day in wards and ≥2 times per day for nurses. Protective factors for infection (OR <1, P <0.05). Conclusion There are more risk factors for nosocomial infection in critically ill patients in emergency department, which should arouse our attention and early intervention to reduce the incidence of nosocomial infection.