重症监护病房患者医疗干预措施与医院感染的相关性研究

Relativity of Invasive Operation and Nosocomial Infection in ICU

目的探讨重症监护病房医疗干预措施与医院感染的相关性。方法对1897例入住重症监护病房的患者进行前瞻性研究,记录观察期内机械通气、中心静脉置管、泌尿道插管等医疗干预措施的时间,分析干预措施种类数及其持续时间与医院感染发生的相关性。结果应用医疗干预措施增加医院感染发生的危险性,并且应用≥2种干预措施的医院感染发生率比仅用1种干预措施的医院感染发生率明显增高;气管切开、机械通气、中心静脉置管、肠内营养等干预可以增加医院感染发生的危险性,并且随其持续时间延长发生医院感染的危险性不同。结论多种医疗干预措施增加医院感染发生的概率,尤其是侵入性操作,在综合考虑患者治疗需要的前提下,应尽量减少过多的医疗干预措施。

OBJECTIVE To study the relativity of medical interventions and nosocomial infection （NI） in ICU. METHODS Totally 1897 ICU patients were enrolled in our study. The time of mechanical ventilation, central vein catheterization, intra-urethral cannulization, etc, was recorded. Then the relativity of medical interventions as well as the time length and NI were investigated. RESULTS The interventions increased the risk of NI, and two or more interventions in combination were more danger ous than single one. Incision of trachea, mechanical ventilation, central vein cannula, intra-urethral cannula and enteral nutrition with different time length increased the risk of NI. CONCLUSIONS Interventions, especially invasive manipulations can increase the risk of NI. We should decrease the number of interventions as far as possible for purpose of decreasing the NI rate.