44例糖尿病患者医院感染危险因素分析及护理干预措施

Risk factors for nosocomial infections in 44 diabetes mellitus patients and nursing interventions

目的分析糖尿病发生医院感染的危险因素,以采取有针对性诊疗护理措施,为有效防治糖尿病医院感染提供科学依据。方法对医院895例糖尿病住院患者的临床资料进行分析,研究其医院感染发生的相关危险因素。结果所有糖尿病患者有44例发生医院感染,感染发生率为4.92%;糖尿病发生医院感染的常见部位呼吸道17例占38.64%、泌尿道12例占27.27%、皮肤7例占15.91%和胃肠道6例占13.64%;感染的病原菌主要为革兰阴性杆菌36株占81.82%,革兰阳性球菌4株占9.09%,真菌3株占6.82%;单因素χ2检验分析,医院感染与年龄、糖尿病病程、血糖控制水平、侵入性操作、住院时间、抗菌药物种类有相关性,logistic多因素回归分析发现,年龄、血糖控制水平、侵入性操作和抗菌药物种类是医院感染发生的独立危险因素。结论糖尿病患者医院感染发生率较高,影响其发生的因素多样,应根据相应情况,采取有针对性的诊疗护理措施,密切监测高龄患者,减少侵入性操作,控制血糖水平,合理应用抗菌药物,降低医院感染的发生。

OBJECTIVE To explore the risk factors of nosocomial infections in the patients with diabetes mellitus so as to take the corresponding nursing and treatment measures and to provide basis for the effective prevention and treatment of nosocomial infections in the diabetes mellitus patients. METHODS The clinical data of 895 hospitalized patients with diabetes mellitus were analyzed, and the risk factors associated with the nosocomial infections were observed. RESULTS The nosocomial infections occurred in 44 patients among all the diabetes mellitus patients with the infection rate of 4.92%. The main infection sites were as follows： respiratory tract （17 cases, 38.64%） ,urinary tract（ 12 cases, 27.27%）, skin tissue （7 cases,15.91%） and digestive tract （6 cases, 13.64 %）. Of all the pathogens causing nosocomial infections, there were 36 （81.82 %） strains of gram-negative bacilli, 4（9.09%） strains of gram-positive cocci, and 3（6.82%） strains of fungi. The univariate x2 test indicated that the nosocomial infections was closely associated with the age, course of diabetes mellitus, control level of blood sugar, invasive manipulation, hospitalization duration, and type of antibiotics. The multivariate logistic regression analysis showed that the age, control level of blood sugar, invasive manipulation and type of antibiotics were the independent risk factors associated with the nosocomial infections. CONCLUSION The incidence of nosocomial infections is high in the diabetes patients and is influenced by many factors. It is necessary to take corresponding nursing measures, to closely monitor the elderly patients, to lessen the invasive operation, to control the blood sugar level, and to reasonably use antibiotics so as to reduce the incidence of nosocomial infections.