慢性心力衰竭患者合并医院感染相关因素及预防对策

Risk factors for nosocomial infections in chronic heart failure patients and prevention countermeasures

目的探讨引起慢性心力衰竭患者医院感染的危险因素及预防对策。方法选择420例慢性心力衰竭患者作为研究对象,总结医院感染发生率、感染部位分布,对医院感染可能因素进行logistic回归分析。结果 420例患者医院感染60例,感染率为14.23%,感染部位构成下呼吸道28例、上呼吸道12例、泌尿道10例、胃肠道8例、口腔2例;logistic回归分析影响医院感染因素包括:年龄≥60岁、心功能分级差、实施侵入性操作、预防应用抗菌药物、住院时间长,OR值分别为3.56、3.23、3.04、2.78、2.69。结论慢性心力衰竭患者医院感染发生率较高,影响因素复杂,加强老年患者管理、积极纠正心力衰竭、严格侵入性操作的指征、合理应用抗菌药物、缩短住院时间以减少医院感染的发生。

OBJECTIVE To Explore the risk factors for nosocomial infections in the chronic heart failure patients and prevention countermeasures.METHODS A total of 420 cases of chronic heart failure patients were selected as the research objects,the incidence of the nosocomial infections and the distribution of infection sites were summarized,the logistic regression analysis of the susceptible factors for nosocomial infections was performed.RESULTS Totally 60 of 420 patients were infected with the infection rate of 4.23%;there were 28 patients with lower respiratory tract infections,12 patients with upper respiratory tract infections,10 patients with gastrointestinal tract infections and 2 patients with oral cavity infections;logistic regression analysis showed that the age more than 60 years,poor cardiac function grading,invasive operation,prophylactic use of antibiotics,and long hospital stay were the risk factors for nosocomial infections,whose OR value were 3.56,3.23,3.04,2.78,and 2.69,respectively.CONCLUSION The incidence of nosocomial infections is high in the chronic heart failure patients,and the risk factors are complex;it is necessary to strengthen the management of the senile patients,actively correct the heart failure,tighten the invasive operation indications,reasonably use antibiotics and shorten the hospital stay so as to reduce the incidence of nosocomial infections.