脑性瘫痪患儿医院感染调查及相关因素分析

The investigation and correlation factor analysis of nosocomial infection in cerebral palsy children

目的调查住院脑瘫患儿医院感染率,探讨医院感染发生的相关因素,为防治提供参考依据。方法对本院康复中心2003年3月至2007年7月1855例次住院脑瘫患儿出院病历资料进行回顾性调查,了解脑瘫患儿院感率和院感发生的部位,并对院感发生与年龄、合并症、其他系统疾病、住院天数的关系进行分析。结果1855例次脑瘫患儿院感按病例计算院感率为44.91%,二次院感率为7.06%,院感部位以呼吸道感染(82.20%)为主,消化道感染(12.72%)次之,院感率在不同年龄段有显著差异(P<0.05),住院天数(OR=1.021,95%C I:1.017～1.025)、有贫血(OR=1.949;95%C I:1.414～2.687)、佝偻病(OR=1.178,95%C I:1.053～1.565)、营养不良(OR=1.736,95%C I:1.324～2.120)是院感发生的危险因素。结论脑瘫患儿院感率高,以呼吸道和消化道感染为主,低年龄、住院时间长、合并贫血、佝偻病、营养不良是脑瘫患儿院感发生的主要危险因素,提高脑瘫患儿免疫力、适当缩短住院治疗天数、治疗其他系统疾病是预防院感发生的重要措施。

Objective： To investigate the incidence rate of nosocomial infection in cerebral palsy （CP） children, to study the correlation factor of it, and find out the available prevention measures. Methods： The datum of 1855 children with CP from Mar 2003 to Jul 2007 was reviewed. In those cases, the incidence rate and the major sites of nosocomial infection were found. The relationship was analyzed between age, types of CP, other system disease, resident days and nosocomial infection. Results ： The incidence rate of nosocomial infection was 44.91% by cases. The second incidence rate was 7.02%. Two major infection sites were respiratory tract （82. 20% ） and malnutrition （ 12. 72% ）. There was significantly difference in ages （ P 〈 0. 05 ）. Hospitalization days （ OR = 1.021, 95%CI： 1.017-1.025）, anemia （0R=1.949; 95%CI： 1.414-2.687）, rickets （0R=1.178, 95%CI： 1.053 - 1. 565） and malnutrition （OR = 1. 736, 95%CI： 1. 324 -2. 120） were the risk factors of nosocomial infection. Conclusions： In CP, the incidence rate of nosoeomial infection is high. The major infection sites are respiratory tract and alimentary tract. Low age, long hospitalization days, anemia, rickets, malnutrition is the risk factors. In order to prevent nosocomial infection, we should raise the immunity of the cases, shorten hospitalization days and remedy other system diseases.