神经外科术后患者发生医院感染的调查分析

Investigation and analysis of nosocomial infections in patients of neurosurgery department

目的探讨神经外科术后患者发生医院感染的情况,为该类患者的临床预防提供参考依据。方法共纳入70例入住神经外科患者,根据患者病情均行外科手术治疗,根据其术后是否发生感染分为感染组与非感染组,应用多因素回归分析进行多因素分析。结果 70例神经外科患者中有10例患者发生感染,感染率为14.3%,呼吸系统感染7例,泌尿系统感染2例,其他1例;感染组患者糖尿病6例占60.0%、手术时间(2.1±1.2)h、住院时间(22.2±3.1)d、白蛋白(32.2±3.1)g/L,明显高于非感染组糖尿病10例占16.7%、手术时间(1.3±0.6)h、住院时间(13.8±4.1)d、白蛋白(41.8±4.1)g/L,两组比较差异有统计学意义(P<0.05);多因素分析显示,既往存在糖尿病史、手术时间延长、住院时间延长、白蛋白水平低下是神经外科患者发生感染的独立危险因素(P<0.05)。结论神经外科手术患者术后发生感染与既往存在糖尿病史、手术时间延长、住院时间延长、白蛋白水平低下存在密切相关性,是其发生的独立危险因素。

OBJECTIVE To discusses the incidence of nosocomial infections in the patients after the nerve surgery so as to provide basis for the clinical prevention of the disease. METHODS A total of 70 cases of patients who hospitalized in the hospital were enrolled in the study, all the patients underwent the surgical treatment according to the condition, and the patients were divided into the infection group and the non-infection group. The multivari- ate regression analysis was performed. RESULTS Of totally 70 cases of patients in the neurosurgery department, the infections occurred in 10 cases with the infection rate of 14.3%, among which there were 7 cases with respira- tory tract infecitons, 2 cases with urinary tract infections, and 1 case with other infections. In the infection group , there were 6 （60.0%） cases with diabetes, with the operation duration of （2.1±1.2 ） hours, the length of hospital stay of （22.2±3.1） days, the level of albumin （32.2±3.1） g/L , while in the non-infection group, there were 10 （16.7%） cases with diabetes , with the operation duration of （1.3±0.6） hours, the length of hospital stay of （13.8±4.1） days, and the level of albumin of （41.8±4.1） g/L, the difference between the two groups was significant （P〈0.05） ; the multivariate analysis showed that the diabetes mellitus history, extension of opera- tion duration , prolonged hospital stay , and the low level of albumin were the independent risk factors of the infec- tions in the neurosurgery department patients （P〈0.05）. CONCLUSION The incidence of the postoperative infec- tions in the neurosurgery department patients is closely related to the diabetes mellitus history, extension of opera- tion duration, prolonged hospital stay, and the low kevel of albumin, which are the independent risk factors.