慢性心力衰竭患者合并医院感染的调查分析

Chronic heart failure patients with nosocomial infection:investigation and analysis

目的调查慢性心力衰竭患者合并医院感染的特征。方法回顾性调查分析2006年6月-2010年6月医院收治的慢性心力衰竭患者临床资料。结果慢性心力衰竭患者合并医院感染110例,感染率为12.09%;呼吸道感染49例、尿路感染36例、肠道感染18例、口腔感染5例、穿刺部位2例;检出病原菌70株:革兰阴性菌29株,占41.43%,革兰阳性菌27株,占38.57%,真菌14株,占20.00%;感染组年龄大、住院时间长、合并疾病多、心功能差、侵入性操作多、预防应用抗菌药物等是医院感染的危险因素,医院感染组死亡率10.91%高于未发生医院感染的2.36%,差异有统计学意义(P<0.05)。结论慢性心力衰竭发生医院感染是难以完全避免的,与多种因素相关,可加重病情,甚至导致死亡,必须纠正心衰治疗原发病,提高患者自身免疫力、合理应用抗菌药物、减少侵入性操作;缩短住院时间。

OBJECTIVE To survey the characteristics of chronic heart failure patients with nosocomial infection. METHODS Retrospective survey and analysis was performed for the clinical data of patients with chronic heart failure during Jun 2006- Jun 2010. RESULTS Chronic heart failure patients with nosocomial infection were in 110 cases （12.09%）, respiratory tract infections in 49 eases, urinary tract infections （36 cases）, intestinal infection in 18 cases, oral infections in 5 cases site in 2 cases, puncture. 70 strains of pathogens were detected：G- bacteria 29 strains （41.43%）, G＋ bacteria 27 strains （38.57M）, fungi 14 strains （20.00M）, the risk factors for nosocomial infections were：the older, longer hospital stay, more concurrent diseases, poor cardiac function, more invasive operations and frequently prophylactic use of antibiotics. The mortality rate in infection group （10. 91%） was higher than that in non-infection group （2. 36%） the difference was statistically significant （P 〈0. 05）. CONCLUSION Chronic heart failure is hard to avoid nosocomial infection because of various factors which can aggravate illness, and even can cause death, so it must correct treatment of primary disease of heart failure, improve the natural immunity of the patients, reasonably use antibiotics, reduce operative operation and shorten hospital stay.