高危孕产妇医院感染分析

Analysis of Nosocomial Infection of High Risk Lying-in Woman

目的分析高危孕产妇医院感染,为防治医院感染寻找对策。方法回顾性分析1999年1月～2003年12月在广州市重症孕产妇救治中心住院的8342例住院孕产妇的病历,对医院感染者逐个进行登记。结果高危孕产妇医院感染发生率为5.34%(237/4441),明显高于正常孕产妇的0.79%(31/3901),P<0.05。高危孕产妇的医院感染主要发生在产后,占85.23%,发生于产前的占14.76%。感染发生的部位以生殖道最多,达94例(39.25%),其余依次为呼吸道77例(32.49%),切口及皮肤54例(22.78%),胃肠道7例(2.95%)、泌尿道6例(2.53%)。剖宫产者和阴道助产者医院感染发生率分别为6.80%和6.29%,均非常显著性地高于自然分娩者(3.11%),P均<0.01。联合应用抗生素者医院感染发生率5.23%,单用抗生素者医院感染率5.74%,二者无显著性差异。结论高危孕产妇容易发生医院感染,感染发生的部位以生殖道、呼吸道、切口及皮肤为主,剖宫产者和阴道助产者会增加医院感染发生的机会,联合应用抗生素并不能降低发生感染的机会。

Objective To explore the status of nosocomial infection of high risk lying-in women and the corresponding interventions. Method By retrospective analysis 8342 lying-in women who were admitted in the Second People＇ s Hospital of Guangzhou from Jun. 1999 to Dec.2003. Results The infectious rate of high risk lying-in woman is 5.34%（237/4441）, which is significandy higher than that of normal lying-in women （0.79%, 31/3901, P 〈 0.05）. 85.23% infection was after childbirth, 14.76% was before childbirth. Genital duct infection（94,39.25%） is primary, the rest in order were espiratory （77, 32.49%）, nick and skin （54, 22.78%）, gastrointestinal tract （7, 2.95%）, urinary tract infection （6,2.53%）. The infectious rate of cesarean delivery and vagina assistant delivery were 6.80% and 6.29% , respectively ,which were significant higher than that of spontaneous labor （P 〈 0.01）. The infectious rate of using combined antibiotics group was 5.23%, using single antibiotics group was 5.74%, there were no difference between two groups. Conclusions High risk lying-in women were high risk group of nosocomial infection . Cesarean delivery and vagina assistant delivery would increase the chance of infection, Infection focuses on genital duct, espiratory, nick and skin. Using combined antibiotics would not decrease infection.