冠心病监护病房医院感染危险因素分析及护理对策研究

Analysis of the related risk factors of nosocomial infection and relevant nursing strategy in coronary care unit

目的：探讨冠心病监护病房（CCU）内医院感染的相关危险因素及护理对策。方法回顾性调查我院CCU 病房2013年8月～2014年8月362例住院患者，分析其医院感染率及相关危险因素并提出预防对策。结果1年平均感染率3.32％；医院感染的病种分布以急性心肌梗死居多；年龄分布以老年患者（＞60岁）居多；感染部位分布以下呼吸道居多；病原菌以革兰阴性菌感染为主；随着年龄的增长医院感染发生率上升；住院时间越长感染发生率越高；多种高危因素同时影响下医院感染发生率上升。结论冠心病监护病房医院感染的主要危险因素包括高龄、住院时间、侵袭性操作、营养不良及并发糖尿病等，应对具有上述危险因素的患者加强病情观察，尤其是加强咳嗽和痰液性质及体温的观察，做好留置管道的护理，加强消毒隔离措施的落实是预防和控制 CCU 患者医院感染的护理对策。

Objective：To analysize the related risk factors of nosocomial infection and put forward relevant nursing strat-egy in coronary care unit. Methods：362 cases of hospitalized patients in coronary care unit in our hospital were surveyed to analysize the related risk factors of nosocomial infection and put forward relevant nursing strategy. Results：The average hos-pital infection rate was 3. 32%. The patients with nosocomial infection suffered mainly from acute myocardial infarction,es-pecially in the elderly patients. Infection sites focused in the lower respiratory tract and the pathogens were mainly Gram -negative bacteria;Nosocomial infection was closely related to the hospitalization duration and concurrence of several risk fac-tors could increased the rates of nosocomial infection. Conclusions：Age,the hospitalization days,invasive operation,mal-nutrition and diabetis are risk factors for nosocomial infection. To deal with the above mentioned risk factors,it is necessary to strengthen the observation of illness process and the cough,sputum properties and temperature. At the same time,abi-dence by aseptic technique in indwelling catheter and enhancement of disinfection - isolation are the useful methods to pre-vent and control for the nosocomial infections.