13例医院感染败血症临床分析

Nosocomial Infection with Sepsis: A Clinical Analysis on 13 cases

目的探讨医院感染败血症密切相关的诱发因素和防控措施。方法采用回顾性调查的方法对13例医院感染败血症临床资料进行统计分析。结果败血症占医院感染例次数的1.67%,死亡率为46.15%;13例患者均有多种严重的基础疾病,9例施行了穿刺导管深静脉留置,3例行动、静脉造瘘血液透析,11例在发生败血症前后出现其他部位感染,4例是由耐药菌株引起的。结论在诸多引起医院感染败血症的医源性危险因素中,静脉穿刺留置导管,是导致医院感染败血症最危险的因素;坚持严格的无菌操作是预防和控制高危患者医院感染败血症的关键环节;除合理应用有效抗生素外,应及时去除血管通路留置的导管,进行血液和导管顶端采样,做细菌学检验及药敏试验。

OBJECTIVE To search for risk factors associated with sepsis of nosocomial infection and evaluate ~prevention measures. METHODS Clinical materials of 13 nosocomial infection patients with sepsis were analyzed by a case retrospective analysis. RESULTS The morbidity of sepsis was 1.67% in all nosocomial infection, but their mortality was 46.15%. All patients had some or severe underlying disorders. Nine were operated by deep vein operation with catheter dwelling, 3 were hemodialyzed through arteria-vein stoma. Infection of other parts of 11 patients occurred before or after sepsis and was caused by some bacterial strains resistant to antibiotics. CONCLUSIONS Among many risk factors of nosocomial infection with sepsis, vein catheter dwelling is the most risk factor. The strict aseptic technique is the key measure to prevent and control nosocomial infection with ~sepsis in risk patients. In addition to using appropriate antibiotics, blood vessel catheters should be plucked ~timely and samples from blood and the top of catheters be tested by bacterial detection and drug sensitive tests.