心内科老年住院患者医院感染的高危因素分析

High risk factors for nosocomial infections in elderly hospitalized patients in department of cardiology

目的探讨分析心内科老年住院患者医院感染的高危因素,对其有效控制感染促进疾病好转提供指导。方法选取2010年1月-2011年1月于心内科住院治疗的200例老年患者为研究对象,将其医院感染发生率及个人因素、治疗性因素对其影响进行研究分析。结果 200例老年患者共发生医院感染31例,发生率为15.50%,主要以呼吸道和泌尿道感染为主,且住院时间≥2周者发生率为25.93%,住院时间<2周者,并发基础疾病种类≥3种者感染率为31.25%,高于<3种者,进行侵入性操作≥3次者为37.50%,高于<3次者,抗菌药物应用≥2种者感染率为26.98%,高于1种者,应用时间≥4周者感染率为20.45%,高于<4周者,ASA分级Ⅳ级感染率为29.73%,高于其他患者,存在其他感染灶者感染率为45.71%,高于其他患者,血浆白蛋白<30g/L者感染率为28.99%,高于≥30g/L者,差异均有统计学意义(P<0.05)。结论心内科老年住院患者医院感染的高危因素较多,在对老年患者进行治疗的过程中应全面给予重视。

OBJECTIVE To investigate and analyze the risk factors for nosocomial infections in elderly hospitalized patients of the department of cardiology so as to effectively control the infections and promote the recsvery. METHODS A total of 200 elderly patients who were treated in the department of cardiology from Jan 2010 to Jan 2011 were chosen as the research objects. The incidence of nosocomial infections and the effects of personal factors and treatment factors on the incidence were studied. RESULTS Nosocomial infections occurred in 31 of 200 elderly patients with the incidence rate of 15.50%, most of which were with reapiratory tract infections and the urinary tract infections. The incidence rate of patients with the hospital stay more than 2 weeks was 25. 93%. The infection rate of the patients with the hospital stay less than 2 weeks and the underlying diseases less than 3 types was 31. 25%, higher than that of the patients with more than 3 types of underlying diseases; the infection rate was higher in the patients with use of more than 2 types of antibiotics （26. 98%） than with more than 1 type of antibiotics. The infection rate was higher in the patients with the antibiotics treatment course more than 4 weeks （20. 45%） than less than 4 weeks. The infection rate of the patients with the ASA classification of grade IV infection rate was 29.73 %, higher than that of the patients with other grades of ASA classification. The infection rate of the patients with foci was 45.71%, higher than that of other patients. The infection rate of the patients with the serum albumin below 30 g/L was 28.99%, higher than that of the patients with serum albumin above 30 g/L, the difference was statistically significant （P〈 0. 05）. CONCLUSION There are many categories of risk factors for the elderly hospitalized patients with nosocomial infections in the department of cardiology, and high attention should be paid to the treatment of the elderly patients.