2006年与2007年住院死亡病例对比分析

Deceased Inpatients in 2006 and 2007:A Comparative Analysis

目的通过对2006、2007年住院死亡病例的对比分析，探讨死亡原因及其与医院感染的关系。方法应用统计学方法对两年住院死亡病例进行分析。结果两年死亡病例医院感染发生率平均为21．44％；死亡以50～80岁为高发年龄段，死亡与住院天数无必然因果关系；医院感染死亡病例主要集中在重症监护病房、神经科、呼吸科；各季度死亡差异无统计学意义；感染部位中下呼吸道感染高居首位，2007年真菌跃居死亡病例病原菌第1位，万古霉素使用率在2007年医院感染死亡病例中高居第1位。结论严格侵入性操作的细节管理，依据病原学结果合理应用抗菌药物、规范医务人员手卫生等医疗行为是保障患者安全、降低医院感染发生率与病死率的有效措施。

OBJECTIVE To discuss the relationship between the reason of death and nosocomial infection through investigating the deceased inpatients in 2006 and 2007. METHODS To analyze the statistics of the deceased inpatients in recent 2 years. RESULTS The average nosocomial infection rate was 21.44 ~ in deceased inpatients in recent two years, among which the inpatients aging between 50 and 80 held the highest death rates. The death had no causal relationship with the duration of hospitalization. Most of the death cases occurred in ICU, neurology department and respiratory department. There was no difference in statistics during the four seasons. Lower respiratory tract infection was the top one among all the infection sites. Fungus was the top one among all the pathogens and vancomycin was the top one antibiotic used in death cases of nosocomial infection in 2007. CONCLUSIONS Strict managing the interventional procedure, choosing antibiotics according to bacteriology result and staffs hands sanitizing are effective measures to reduce the nosocomial infection rate and mortality.