神经外科重症监护病房医院感染的调查分析

Investigation of nosocomial infection and nursing strategies in Neurointensive Care Unit

目的调查分析神经外科重症监护病房（NICU）医院感染发生情况、原因和危险因素，探讨护理干预措施。方法回顾性分析NICU927例患者年龄，疾病种类、感染的部位、原因、病原菌种类、危险因素等临床资料。结果927例患者巾，发生医院感染116例，医院感染率为12．5％，60岁以上患者感染率最高；疾病种类以重型颅脑损伤、脑血管疾病的感染率最高；感染部位依次为呼吸道、泌尿道、胃肠道；189例次医院感染总共检出96株病原菌，依次是铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯菌、白色念球菌、金黄色葡萄球菌；并与创伤性操作、机体抵抗力下降、抗菌药物应用不合理、医务人员缺乏交叉感染意识、住院天数长和高龄等因素有关。结论NICU医院感染发生率高，应加强护理干预措施．包括病室管理、规范洗手、严格遵守无菌原则、改善环境因素和治疗操作中易导致污染和感染的环节、以及对呼吸、泌尿系统的护理，合理应用抗生素、缩短住院时间等措施才能有效的预防NICU的医院感染。

Objective To analyze the incidence, causes and risk factors of nosocomial infections in Neurointensive Care Unit（ NICU）, and to investigate the measures of nursing intervention. Methods The clinical data of 927 cases in NICU were analysed retrospectively, included age, entity, location infected, reason, pathogenic bacteria , risk factor et c. Results In the 927 cases, nosoctomial infection occurred in 116 cases, the incidence of nosoeomial infections was 12.5% （116/ 927 ）, nmximal in patients over 60 years old, the infection rate of severe brain injury and cerebral vascular diseasesw as the highest in all diseases. The common infection sites were respiratory tract, urinary tract and gastrointestinal tract in turn. 94 pathogenic bacterias were detected in total 189 infection frequencies, including pseudomonas aeruginosa, baumanii, white Candida, staphylococcus aureus, in turn. The infection had relations to many risk factors , such as the traumatic operation, low resistance of body, unreasonable application of antiseptic drugs, medical personnel＇s deficiency of cross infection conscioushess, hospitalization for long time, elder patients, and so on. Conclusion The incidence of nosocomial infections in N1CU is high. The intervention measures of nursing care need be enhanced, including strengthening the management of ward, medical hand -washing, observing the aseptic principle seriously, improving the enviroment and links which could easilylead to pollution and infection in the operations, nursing intervention of respiratory and urinary systems, utilizing the antibiotics reasonably, shorten the time of hospitalization et c. So to prevent the nesocomial infection efectively.