老年冠心病患者医院感染的相关因素分析

Related factors of nosocomial infections in elderly patients with coronary heart disease

目的探讨影响老年冠心病患者发生医院感染相关因素,为控制老年冠心病患者发生医院感染提供依据。方法回顾性分析2011年1月-2012年12月80例发生医院感染的老年冠心病住院患者临床资料,并选取同期80例未发生医院感染的老年冠心病患者临床资料进行对比,对其住院时间、病房环境、侵入性操作、并发症、心功能分级及抗菌药物使用等进行分析。结果 533例老年患者中发生医院感染80例,感染率为15.0%;单因素回归分析发现,住院时间、病房环境、并发症、心功能分级及侵入性操作与医院感染的发生有关,差异有统计学意义(P<0.05),年龄、性别、病程及抗菌药物应用对老年冠心病患者医院感染无明显影响;经多因素回归分析发现,住院时间长、病房环境差、合并其他慢性疾病、心功能分级Ⅲ～Ⅳ级及存在侵入性操作均为影响老年冠心病患者医院感染的独立因素(P<0.05)。结论住院时间长、病房环境差、合并其他慢性疾病、心功能分级Ⅲ～Ⅳ级及存在侵入性操作均为影响老年冠心病患者医院感染的独立因素,医护人员应严格无菌操作、缩短操作时间、降低患者感染风险,改善其生存质量。

OBJECTIVE To explore the factors associated with nosocomial infections in the elderly patients with coronary artery disease so as to provide basis for the control of nosocomial infections in the elderly patients with coronary heart disease. METHODS The clinical data of 80 cases of elderly patients with coronary heart disease and nosocomial infections who were treated in the hospital from Jan 2011 to Dec 2012 were retrospectively analyzed, and 80 cases of elderly patients with coronary heart disease, who were without nosocomial infections during the same period, were set as controls, then the length of hospital stay, ward environment, invasive operation, compli- cation, cardiac function grading , and use of antimicrobial agents were analyzed. RESULTS Of 533 cases of elderly patients, the nosocomial infections occurred in 80 cases with the infection rate of 15.0%. The univariate analysis showed that the hospitalization duration, environment of ward, complications, cardiac function grading, and inva- sive operation were associated with the incidence of nosocomial infections, the difference was statistically signifi- cant （P〈0.05）, and the age, gender, disease course, or use of antibiotics was not significantly correlated with the incidence of nosocomial infections in elderly patient with coronary heart disease. The multivariate regression analysis indicated that the long duration of hospitalization, poor ward environment, complication with other chron- ic diseases, heart function grading ranging from Ⅲ to Ⅳ, and invasive operation were the independent factors of nosocomial infections in elderly patients with coronary heart disease （P〈0.05）. CONCLUSION The long duration of hospitalization, poor ward environment, complication with other chronic diseases, heart function grading ran- ging from Ⅲ to Ⅳ, and invasive operation are the independent factors of nosocomial infections in elderly patients with coronary heart disease. It is necessary for the medical staff to rigidly perform the aseptic operation, shorten the operation duration, reduce the risk of infections, and improve the life quality of the patients.