糖尿病并发医院感染的危险因素研究

Analysis of Risk Factors of Nosocomical Infection in Patients with Diabetes Mellitus

目的:探讨糖尿病医院感染状况与危险因素,为有效的防治糖尿病医院感染,降低其发病率提供科学依据。方法:对糖尿病患者医院感染的易感因素采取回顾性调查和分析。结果:糖尿病医院感染的病例为同期全部住院病例的0.44％,占同期住院糖尿病患者的36.82％,占全院同期医院感染构成比的13.64％。糖尿病患者医院感染的病死率为38.27％。糖尿病医院感染患者的危险因素包括:年龄、糖尿病病程、住院天数、滥用抗生素、血糖的控制程度、手术及侵袭性操作、糖尿病患者的慢性基础性疾病、糖尿病的并发症等。糖尿病医院感染的感染部位主要为肺部、泌尿道、切口、血液及肠道。主要病原体为真菌和革兰氏阴性菌。结论:糖尿病患者医院感染发病率高,病死率高,必须引起重视。积极治疗原发病,缩短住院时间,合理使用抗生素,注意无菌操作,避免不必要的手术及侵袭性操作是预防糖尿病医院感染的重要环节。

Objective To explore the state of nosocomical infection and its risk factors in patient with diabetes mellitus in order to provide scientific basis for the effective preventing and treating it and to lower its morbidity. Method The sensitive factors of nosocomical infection in patients with diabetes mellitus were investigated and analyzed retrospectively. Results The cases of diabetes mellitus complicated by nosocomical infection accounted for 0.44% of the whole inpatients,36.82% of hospitalized patients with diabetes mellitus and 13.64 % of the total patients with nosocomical infection during the same period. Their mortality was 38.27 % . The risk factors of nosocomical infection in the patients with diabetes mellitus included the age,course of the disease, the days of hospitalization,abusing antibiotic drugs,control level of blood sugar,operation or invasive manipulation, the other chronic diseases and complications,etc. The nosocomical infection could occur in multiple organs, but mainly in the lung, urinary tracts, intestinal incison and blood. Chief among the pathogens were fungus and Gram negative bcteria. Conclusions In patients with diabetes mellitus the nosocomical infection incidence is relatively high and the mortality in the patients with diabetes mellitus complicated by the nosocomical infection was also high. The important links in a chain of preventing the nosocomical infection inclnde active treatment of the original disease, shortening time of hospital stay, reasonable use of antibiotics and avoiding unnecessary operation and invasive manipulation in the patients with diabetes mellitus.