冠心病患者医院感染因素分析及预防

Related factors for nosocomial infections in coronary heart disease patients and prevention countermeasures

目的了解冠心病患者发生医院感染的构成因素,以便采取有效预防措施。方法对2009年6月-2012年6月收治的2346例冠心病患者进行回顾性调查。结果有96例医院感染患者,感染率为4.1%;患者中≥60岁的占76.04%,<60岁占23.96%,与年龄、有无侵入性操作和住院时间有关,差异有统计学意义(P<0.05);感染部位以呼吸道为主,占59.17%,其次为泌尿道占19.17%;共分离出病原菌72株,其中革兰阴性菌占70.8%,革兰阳性菌占18.0%,真菌占11.2%,前3位病原菌依次为铜绿假单胞菌、肺炎克雷伯菌、肠球菌属,分别占26.4%、11.1%、9.7%。结论提高患者机体免疫力、缩短住院时间、避免侵入性操作、加强护理、做好消毒隔离等可有效降低医院感染的发生。

OBJECTIVE To investigate the related factors for nosocomial infections in the coronary heart disease patients so as to take effective measures. METHODS A total of 2346 cases of coronary heart disease patients who were treated from Jun 2009 to Jun 2012 were retrospectively investigated. RESULTS Totally 96 cases of patients were infected with the infection rate of 4.1% ; the patients with more than 60 years of age accounted＇ for 76.04 % , the patients with less than 60 years of age accounted for 23.96 %, the incidence of infections was related to the age, invasive operation, and hospitalization duration, the difference was statistically significant （P〈0.05）. The respiratory tract （59.17%） ranked the first place of the infection sites, followed by the urinary tract （19.17%）. Totally 72 strains of pathogenic bacteria were isolated, including the gram-negative bacteria （70.8%）, the gram- positive bacteria （18.0 %）, and the fungi（11. 2 %）. The Pseudomonas aeruginosa, K lebsiella pneumoniae, and Enterococcus were the top three species of pathogens, accounting for 26.4%, 11.1 %, and 9.7 %, respectively. CONCLUSION Enhancing the immune function of the patients, shortening the hospitalization duration, avoiding the invasive operation, and intensifying the nursing care as well as the disinfection and isolation can reduce the incidence of nosocomial infections effectively.