泌尿外科住院患者合并医院感染的临床特征分析

Analysis of clinical features of urology inpatient hospital infection

目的探讨泌尿外科住院患者医院感染的临床特征及对策。方法 2006年1月～2009年12月在该院泌尿外科住院且合并医院感染的78例患者作为观察组,按照1∶2的比例选择无医院感染的同期泌尿外科患者156例作为对照组,观察感染部位、病原菌检查结果、医院感染对预后的影响;同时比较两组患者相关医院感染等指标的差异。结果 78例医院感染中泌尿道感染47例,呼吸道感染21例,切口感染7例,胃肠道感染3例;具有感染典型表现60例,18例症状不典型;观察组共送标本160份,检出病原微生物104份,G-菌43株,G+菌41株,真菌20株;年龄大、侵袭性操作、合并基础性疾病、留置尿管、留置尿管时间长和住院时间长是医院感染的危险因素;预防应用抗生素不能降低医院感染;观察组中死亡5.13%,高于对照组中的1.28%。结论泌尿外科住院患者合并医院感染有时难以避免,应改善老年患者局部和全身状况;减少侵袭性操作,并及时终止;掌握插尿管适应证及留置尿管时间;注重对抗生素的合理选择,及时送检各种标本;缩短住院天数。

【Objective】 To study the clinical characteristics of nosocomial infection and countermeasures in urology department.【Method】 From January 2006 to December 2009,78 cases of hospitalized urological patients with nosocomial infection were selected as the observation group,in accordance with 1∶2 ratio selection without nosocomial infection in patients with the same period 156 cases of urology as a control group for observing the site of infection,pathogen test results,hospital infection on the prognosis;the same time patients with nosocomial infection and other indicators related to the differences were compared.【Result】 78 cases of hospital infection contained 47 cases of urinary tract infection,21 cases of respiratory tract infection,7 cases wound infection,3 cases gastrointestinal tract infection;60 cases of a typical expression of infection,18 cases of atypical symptoms;A total of 160 specimens had 104 positive detection of pathogenic micro-organisms,G-bacteria 43,G＋ bacteria 41 and fungi 20;The old age,invasive operations,consolidated basis,diseases,retention of urine tube,indwelling catheter for a long time and hospital stay are risk factors for nosocomial infection;preventive use of antibiotics can not reduce hospital infection;the observation group died was 5.13%,higher than 1.28% of control group.【Conclusion】 Urology inpatients complicated with hospital infection is sometimes difficult to avoid,doctors should increased local and systemic conditions of the elderly patients;less invasive operation,and promptly termination;to grasp catheter insert indication and indwelling catheter time;focus on the rational choice of antibiotics,timely submission of various specimens;shorten the hospitalization days.