糖尿病住院患者感染分布特征与护理对策

Characteristics of infectious distribution and nursing countermeasures in Diabetic Inpatients

目的了解糖尿病住院患者合并感染的分布特征,探讨有效的护理对策。方法收集2008年1月～2010年4月我科103例糖尿病合并感染住院患者,了解其标本来源、常见病原菌等感染分布特征,探讨预防和治疗合并感染的有效护理措施。结果糖尿病合并感染住院患者以中老年为主。标本种类以尿、痰液为主,分别为44份(38.9%)和31份(27.4%),其次主要为血液、骨髓15份(13.3%)和分泌物11份(9.7%)。病原菌包括革兰阴性菌73株(61.9%)、革兰阳性菌33株(28.0%)和真菌12株(10.1%),以革兰阴性杆菌为最多,其中以大肠埃希菌28株(23.7%)和鲍曼不动杆菌13株(11.0%)为主,革兰阳性菌以葡萄球菌属为主(24株),真菌主要为白假丝酵母菌(10株)。结论糖尿病住院患者是医院感染的易感人群,而感染易引起血糖难以控制。因此,在积极控制血糖同时,落实健康教育、加强护理管理和基础护理、积极控制感染等护理措施,以防控糖尿病患者感染的发生。

Objective The purpose of this study was to investigate the characteristics of nosocomial infection and explore the variety of main nursing countermeasures in diabetic inpatients. Methods Retrospectively collected 103 cases of diabetic inpatients, who were concurrent infection in endocrinology department of our hospital from 2008 to April 2010. To analysed the charac- teristics of pathogenic bacteria and several nursing interventions were carried out aimed at various condition. Results Themajor of nosocomial infection in diabetes patients were the elderly diabetics in our study. 118 nonduplicate strains of pathogenic bacteria were collected, and the main origin specimens were urine（38. 9%） and sputamentum（27. 4%）. Among 118 strains of pathogens, gram--positive organisms accounted for 28. 0% of isolates, while gram--negative for 61.9% and fungus for 10. 1%. The commonest pathogens causing nosocomial infection were Escherichia coil. （23. 7%）, and Acinetobacter baumannii （11.0%）. Ten strains of Candida albicans were detected in this study, and were the major of fungus. Conclusion The infection was closely associated with diabetes mellitus. It is essential to treat the primary affection positively. Several measures, such as improving nursing countermeasures and supervision, using antibiotic reasonably, taking the steps of prevention and so on can actively cut down the incidence rate of nosocomial infection in diabetics.