综合性ICU院内感染的原因分析及防护措施

The cause and protective measures of infection in comprehensive ICU

目的探讨综合性ICU院内感染的发病情况,寻找防护措施。方法对2007年1月至2008年12月间ICU院内感染36例患者进行回顾性分析结果ICU院内感染中以老年患者居多(尤其为老年男性),感染部位以下呼吸道、切口感染、泌尿道、血液常见,疾病以重型颅脑损伤、糖尿病、高血压危象、脑出血、胆道疾患、腹膜炎感染最高,并与创伤性操作、机械通气、鼻饲、医务人员缺乏交叉感染意识、没有严格执行无菌技术操作原则、机体抵抗力下降、不合理使用抗生素有关。结论加强ICU管理,改善环境因素、减少医源性危险因素的产生和损伤、提高机体抵抗力、合理使用抗生素等是预防ICU院内感染的有效措施。

Objective Through discussing incidence of infection in comprehensive ICU, we discovered the protective measures. Methods Our investigation analyzed the 36 cases of infection in comprehensive ICU from 2007.1 to 2008.12 retrospectively. Results The senile patients were in the majority （ elderly man, especially）. The common location of infection included lower respiratory tract, incision, urinary tract and blood. The common diseases included heavy eraniocerebral injury, diabetes, hypertensive crisis, encephalorrhagia, disease of biliary tract and peritonitis. The incidence was related to traumatic manipulation, mechanical ventilation, nasogastric feeding, no consciousness of cross infection and not strict execution of sterile operation, decline of resistance and inappropriate antibiotic use. Conclusion The measures - strengthening management of comprehensive ICU, improving the environment, reducing occurrence and injury of iatrogenic risk factors, improving body resistance and using antibiotic appropriately, were effective for preventing bacterial infection in comprehensive ICU.