不动杆菌下呼吸道感染的危险因素分析及护理

Acinetobacter infection in the lower respiratory tract: An analysis of risk factors and nursing

目的探讨下呼吸道不动杆菌感染的危险因素,进一步讨论其护理策略。方法选择不动杆菌下呼吸道感染病例资料56例,同期60例非不动杆菌感染的病例作为对照进行回顾性分析,选择可能引起不动杆菌感染的常见因素进行单因素分析,对有统计学意义的因素再进行多因素的Logistic回归分析,发现存在的独立危险因素,并在此基础上讨论护理策略及防控措施。结果 Logistic多因素回归分析：和非感染组比较,感染前抗生素使用超过2周且碳青霉烯类使用超过1周（P值=0.0095;OR值：7.32;95%可信区间：3.56~11.32）;感染前糖皮质激素使用超过2周（P值=0.0179;OR值：6.95;95%可信区间：3.96~9.98）;气管插管或气管切开超过2周（P值=0.0063;OR值：5.63;95%可信区间：3.23~10.71）;粒细胞缺乏症（〈0.5×109/L）且持续大于10d（P值=0.0029;OR值：4.74;95%可信区间：2.23~6.68）。结论感染前抗生素使用超过2周且碳青霉烯类使用超过1周;感染前糖皮质激素使用超过2周;气管插管或气管切开超过2周;粒细胞缺乏症（〈0.5×109/L）且持续大于10 d,这4个因素是下呼吸道不动杆菌感染的独立危险因素。

Objective To study the risk factors of Acinetobacter infection in lower respiratory tract,and further discuss the nursing strategies.Methods A total of 56 cases of Acinetobacter lower respiratory tract infections were selected as study group and another 60 non-Acinetobacter cases were selected as control group.The clinical data of both groups were retrospectively analyzed.Single-factor analysis was conducted to commonly-seen factors that led to Acinetobacter infections.Logistic regression analysis was conducted to factors of statistical significance in order to identify independent risk factors.The nursing strategies and prevention and control measures were discussed subsequently.Results Compared with the non-infectious group,the results of Logistic multi-factor regression analysis identified four factors as independent risk factors： antibiotics taken over two weeks and carbapenems over one week before infection（P=0.0095;OR：7.32;95% confidence interval： 3.56-11.32）,glucocorticoid over two weeks before infection（P=0.0179;OR：6.95;95% confidence interval： 3.96-9.98）,endotracheal intubation or tracheostomy over two weeks（P=0.0063;OR： 5.63;95% confidence interval： 3.23-10.71）,and granulocyte deficiency（〈0.5×109/L）lasting over 10 days（P=0.0029;OR： 4.74;95% confidence interval： 2.23-6.68）.Conclusion The results suggest that the above four factors were the independent risk factors associated with Acinetobacter lower respiratory tract infection.