144例产妇院内感染分析及护理对策

Analysis of Nosocomial Infections in 144 Parturients and the Nursing Strategies

目的分析产科院内感染现状并探讨相应的预防措施。方法回顾性分析5年中发生院内感染的144例产妇临床资料，比较不同分娩方式产妇发生院内感染的部位，并对院内感染的病原菌和抗生素使用情况进行分析。结果院内感染的主要部位依次为手术切口、上呼吸道、泌尿道、生殖道、乳腺等，而且剖宫产术与会阴侧切术后发生院内感染的部位有统计学差异（P〈0．05）；144例发生院内感染的产妇中，有81例进行了病原学检查，送检率为56．25％，共培养出53株病原菌；抗生素使用率为78．47％，最多达5种，用药天数5～15d。结论产妇院内感染的发生与其个体因素、分娩方式、环境因素及抗生素的应用均有关；积极治疗妊娠合并症、提高分娩助产技术、杜绝环境中的不良因素、合理应用抗生素是预防产科院内感染的有效措施。

Objective To analyze the current status ot nosocomlal infectlons in the aepartment of obstetrics and explore the corresponding preventive measures. Methods A retrospective analysis was conducted among 144 parturients acquiring nosocomial infections in 5 years. The sites of infections in relation to different delivery modes were compared, and the pathogens causing the infections and use of antibiotics were analyzed. Results The sites of infections mainly included, in the order of frequency, the incisions, upper airway, urinary tract, genital tract, and the mammary glands; the infection sites showed significant differences between cesarean and mediolateral episiotomy. Of the 144 parturients with nosocomial infections, 81 were examined for the pathogens, with an examination rate of 56. 25%, and 53 strains of pathogenic bacteria were isolated. The rate of antibiotics application was 78.47 %, involving a maximum of 5 antibiotics with a duration of antibiotics use ranging from 5 to 15 days. Conclusion The occurrence of nosocomial infections in the department of obstetrics is associated with the individual condition of the parturients, delivery mode, environmental factors and use of antibiotics. Active treatment of pregnancy-related compli- cations, improving the techniques for assisting the delivery, elimination of the environmental risk factors and adequate use of the antibiotics are effective measures for preventing the occurrence of nosocomial infections.