神经内科住院患者并发下呼吸道感染的危险因素分析

Risk factors of lower respiratory tract infections in hospitalized patients of neurology department

目的分析神经内科住院患者并发下呼吸道感染的危险因素,为预防医院感染提供理论依据。方法分析医院神经内科2009年1月-2011年12月207例并发下呼吸道感染患者的临床特征,并选择同期未发生感染的住院患者240例作为对照,对两组间相关变量做单因素分析及logistic回归分析。结果经单因素分析,年龄、基础疾病、不良生活习惯、意识障碍、侵入性操作、抑酸剂、糖皮质激素、脱水剂、抗菌药物、住院时间是引起神经内科住院患者并发下呼吸道感染的主要相关因素(P<0.05);应用logistic回归分析,筛选出高龄、有基础疾病史、不良生活习惯、意识障碍、滥用抗菌药物为引起神经内科住院患者并发下呼吸道感染的危险因素,其OR值分别为8.120、2.239、9.199、4.476、2.789。结论医院感染是神经内科常见的并发症,针对危险因素,采取有效预防控制措施,改变不良生活习惯、昏迷患者的促醒治疗以及严格执行无菌操作是预防医院感染的重要手段。

OBJECTIVE To analyze the risk factors of lower respiratory tract infections in hospitalized patients of neurology department so as to provide theoretical basis for prevention of nosocomial infections. METHODS The clinical features of 207 patients with lower respiratory tract infections who were treated in the neurology depart-ment from Jan 2009 to Dec 2011 were analyzed, meanwhile, totally 240 hospitalized patients without infections were selected as controls. Univariate analysis and logistic regression analysis were conducted for the relevant variables between the two group. RESULTS The univariate analysis indicated that the age, underlying disease, bad living habit, disturbance of consciousness, invasive procedures, antacids, corticosteroids, dehydrating agent, antibacterial drugs, and the hospitalization duration were the main risk factors associated with the lower respirato-ry tract infections in the hospitalized patients of neurology department（P〈0.05）. The logistic regression analysis screened out the old age, underling disease history, antibiotics, which were the risk factors of the lower bad iiving habit, disturbance of consciousness ,and abuse of respiratory tract infections in the hospitalized patients in neu- rology department, the OR values were 8. 120, 2. 239, 9. 199, 4. 476, and 2. 789 , respectively. CONCLUSION Nosocomial infection is a common complication of the neurology department patients. According to the risk factors , it is necessary to take effective prevention and control measures to change the bad living habit and awaking treat-ment of the coma patients and to strictly implement the aseptic operation so as to prevent the nosocomial infec-tions.