老年脑卒中患者医院感染的危险因素

Risk factors for nosocomial infections in senile patients with strokes

目的分析老年脑卒中患者并发医院感染的危险因素。方法选择778例脑卒中患者,对其中并发医院感染的82例患者临床资料进行统计学分析。结果脑卒中患者医院感染82例,感染率为10.5%,其中年龄60～69岁为5.0%、70～79岁为8.6%、≥80岁为32.8%;住院时间<1个月为8.9%、≥1个月为12.8%;有侵入性操作为18.3%、无侵入性操作为9.3%;有糖尿病合并症为14.5%、无糖尿病合并症为8.8%,有多脏器功能衰竭者为72.3%、无多脏器功能衰竭者为3.2%;医院感染部位以呼吸道为主,占56.1%,其次为泌尿道,占23.2%;细菌学检查分离出病原菌84株,其中以革兰阴性菌为主,占58.3%,革兰阳性菌占29.8%,真菌占11.9%。结论老年脑卒中并发医院感染的危险因素较多,以革兰阴性菌为主要病原菌。

OBJECTIVE To investigate the risk factors for nosocomial infections in senile stroke patients.METHODS A total of 778 cases of senile stroke patients were selected as research objects,and the 82 patients with nosocomial infection were analyzed.RESULTS There were 82 storke cases got nosocomial infections,with the infection rate of 10.5%.There was correction between the patients＇ ages [5.0%（60-69） vs 8.6%（70-79） vs 32.8%（≥80）],hospitalization time[8.9%（1 month） vs 12.8%（≥1/month）],whether or not underwent invasive operation（18.3% vs 9.3%）,and diabetes（14.5% vs 8.8%）,and multiple organ failure（72.3% vs 3.2%）.Hospital-based respiratory tract infections accounted for 56.1%,followed by urinary tract（23.2%）.A total of 84 strains of pathogens were isolated through bacteriology examination,among which gram-negative bacteria accounted for 58.3%,gram-positive cocci accounted for 29.8% and fungi accounted for 11.9%.CONCLUSION There are many risk factors for nosocomial infections in the senile patients with stroke,and gram-negative bacteria were the major pathogens.