医院内感染的防治与对策

Prevention and Cure of Nosocomail Infection

通过我院749例调查,院内感染率9.6％。其中ICU62.5％,心胸外科26.67％,呼吸内科15.09％,创伤科15.38％,神经外科14.39％。侵入途径:呼吸>切口>消化>泌尿系。随入院时间延长发病率增加,4周以上高达54.73％,病死率31.94％。发病因素:关涉到宿主防御机能减退,侵袭性操作检查多,抗生素的广泛应用。机会菌感染的增多。提高对院内感染的认识,加强领导;加强院内高危区环境的管理;严格掌握侵袭性操作技术与抗生素的合理应用;将有传染性疾病与无传染性疾病分开;加强消毒与灭菌措施等应为防制医院内感染的有效对策。

Through a survey on 749 cases, it was found that nosocominal infection rate was 9.6%. The infection rate in ICU was 62.5%, 26.67% in thoracic surgery, 15.0% in respiratory division. 15.38% in trauma division, and 14.39% in neurosurgery. The ways of invading included breathing which was fol- lowed by incision, digestion and urinary system successfully. The morbidity increased with the time passing by and accounted for 54.73% at fourth week, and fatality rate was 31.44%. The pathogenic factors were as follows: defense function descending, too much invasive manipulation, wide spread use of anti- biotics, and increase of accasional infection. Measures: (1)more attention should be payed to nosocominal infection and leadership; (2)enhancing the management of high risk enviroment in the hospi- tal; (3)being well aware of invasive manipulative technics and rational use of antibiotics; (4)separation of patients with infectious disease from those without it, and (5)intensifing sterilization and disinfection.