神经外科病房建立人工气道患者呼吸道感染管理与控制措施

Establishment of control measures of respiratory tract infections in artificial airway patients in neurosurgery ward

目的分析神经外科病房建立人工气道患者呼吸道感染病原菌分布,并提出护理预防控制措施,为减少呼吸道感染提供参考依据。方法回顾性分析2011年1月-2012年3月神经外科病房70例人工气道患者痰培养结果。结果 70例患者中有54例痰培养结果阳性,感染率77.1%;共分离97株病原菌,革兰阴性菌67株占69.1%,以肺炎克雷伯菌为主占21.6%;革兰阳性菌27株占27.8%,以金黄色葡萄球菌为主占15.4%;真菌为白色假丝酵母菌3株占3.1%。结论神经外科病房建立人工气道患者是呼吸道感染的高危人群,加强病原菌监测,合理使用抗菌药物,严格遵守消毒隔离制度,认真执行标准预防和手卫生的落实等,是预防和减少呼吸道感染的有效途径。

OBJECTIVE To analyze the distribution of pathogenic bacteria causing respiratory tract infections in artificial airway patients in neurosurgery ward and put forward the nursing prevention and control measures so as to provide basis for reducing the incidence of the respiratory tract infections.METHODS The results of sputum specimen culture for 70 artificial airway patients who enrolled the neurosurgery ward from Jan 2011 to Mar 2012 were retrospectively analyzed.RESULTS Of 70 patients investigated,there were 54 cases with the sputum cultured positive and the infection rate of 77.1%.A total of 97 strains of pathogens were isolated,there were 67（69.1%） strains of gram-negative bacteria,among which Klebsiella pneumoniae strains accounted for 21.6%.There were 27（27.8%） strains of gram-positive bacteria,among which Staphylococcus aureus strains accounted for 15.4%.There were 3（3.1%） strains of Candida albicans.CONCLUSION The artificial airway patients in the neurosurgery department are the population at high risk of the respiratory tract infections.It is an effective way to prevent and reduce the incidence of respiratory tract infections to strengthen the monitoring of the pathogens,reasonably use antibiotics,rigidly conform to the disinfection and isolation system,and carefully implement the prevention standards and hand hygiene.