住院精神病患者感染性腹泻影响因素病例对照研究

Case-control study on risk factors for infectious diarrhea diseases in patients with mental disorders

目的调查住院精神病患者感染性腹泻的影响因素,为医院感染的控制与预防提供依据。方法对2008年1月-2010年12月确诊为医院感染性腹泻的64例住院精神病患者进行回顾性调查,按照1∶2的比例,选择同一时期、同一病区、同性别、年龄相差≤2岁、未发生腹泻的精神病患者作为对照组,做单因素回归分析和多因素条件logistic回归分析。结果单因素条件logistic回归分析,文化程度、疾病类型、躯体疾病、自制力、长期服药史、合并其他躯体疾病、生冷食物、零食、饮水习惯、洗手习惯、一周前服用抗菌药物、季节为住院精神病患者医院感染性腹泻危险因素(P<0.05);经多因素分析OR值分别为:夏秋季节19.347(5.386～23.476)、合并躯体疾病6.821(2.457～19.642)、无自制力4.446(1.809～18.934)、洗手习惯差3.892(1.743～16.973)、生冷食物3.642(1.672～12.652)、饮冷水3.243(1.462～10.354),与老年抑郁症状的发生显著相关,差异有统计学意义(P<0.05)。结论住院精神病患者感染性腹泻的独立危险因素为季节、躯体疾病、自制力、洗手习惯、生冷食物、饮水习惯。

OBJECTIVE To investigate the influencing factors for infectious diarrhea diseases in patients with mental disorders,so as to provide basis for prevention and control of nosocomial infections.METHODS A total of 64 cases of infectious diarrhea in hospitalized psychiatric patients were retrospectively surveyed from Jan 2008 to Dec 2010.In a ratio of 1：2,the patients hospitalized during the same period,the same ward,same sex,age difference of less than±2 years old,without diarrhea were set as the control group,then the univariate regression analysis and multivariate logistic regression analysis were carried out.RESULTS Univariate logistic regression analysis indicated that the education level,type of disease,physical illness,insight,medication history,combination with other physical diseases,cold food,snacks,drinking habits,hand washing habits,antibiotics taken a week ago,and the season were the risk factors for infectious diarrhea in hospitalized patients with metal disorders（p≤0.05）;multivariate analysis showed that the OR value of summer and autumn,combined physical disease,no insight,poor hand-washing habits,cold food,drinking cold water habits,and depressive symptoms were 19.347（5.386-23.476）,6.821（2.457-19.642）,4.446（1.809-18.934）,3.892（1.743-16.973）,3.642（1.672-12.652）,and 3.243（1.462-10.354）,respectively.CONCLUSION The season,physical illness,insight,hand-washing habits,cold food,and drinking habits are the independent risk factors for the infectious diarrhea in mentally ill patients.