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目的:探讨神经内科重症监护室(NICU)住院患者发生感染的特点及预防措施。方法:对2012年1-7月我院NICU中133例住院患者发生感染的临床资料进行回顾性调查分析。结果:133例NICU住院患者中,46例发生感染,感染发生率为34.6%;感染部位以下呼吸道为最常见,占91.3%,其次为泌尿道、胃肠道。共检出病原菌67株,其中革兰阴性菌51株,革兰阳性菌8株,真菌8株。年龄>60岁的患者感染率(36.6%)明显高于年龄≤60岁的患者(23.8%)(P<0.05);意识昏迷状态(100%)和留置胃管(42.1%)、留置尿管(40.2%)及气管插管、切开(100%)等因素使患者易感性增加(P<0.01)。结论:NICU住院患者是发生感染的高危人群,感染发生率高,危险因素较多且复杂,往往相互叠加起作用。应针对这些危险因素进行重点预防和控制,如减少侵入性操作,尽量缩短侵入性操作时间,缩短留置导管的时间;加强NICU环境管理,减少进出人员次数,严格执行消毒隔离制度及无菌技术操作原则;加强医务人员手卫生依从性。
Objective: To investigate the characteristics and preventive measures of inpatients in Neurology intensive care unit (NICU). Methods: The clinical data of 133 inpatients with NICU in our hospital from January to July in 2012 were analyzed retrospectively. Results: Of the 133 NICU inpatients, 46 cases were infected with the infection rate of 34.6%. The respiratory tract below the infected site was the most common, accounting for 91.3%, followed by the urinary tract and gastrointestinal tract. A total of 67 pathogens were detected, including 51 Gram-negative bacteria, 8 Gram-positive bacteria and 8 fungi. The infection rate of patients aged> 60 years (36.6%) was significantly higher than that of patients ≤60 years old (23.8%) (P <0.05); consciousness coma (100%) and indwelling gastric tube (42.1% (40.2%) and tracheal intubation, incision (100%) and other factors increased the susceptibility of patients (P <0.01). CONCLUSIONS: NICU inpatients are at high risk of infection, with a high incidence of infection and more and complicated risk factors, which often add to each other. We should focus on prevention and control of these risk factors, such as reducing invasive procedures, minimizing invasive operation time and shortening catheterization time; strengthening NICU environmental management, reducing the number of personnel entering and exiting, strictly implementing disinfection and isolation system and aseptic technique Principles; to strengthen medical staff hand hygiene compliance.