儿童肾病综合征医院感染调查分析

Investigation and analysis of hospital infection in childhood nephrotic syndrome

为探讨儿童原发性肾病综合征 (肾病 )医院感染的危险因素及其防治措施 ,我们收集了1991～ 1999年肾病住院患儿 190例 ,采用单因素分析及Logistic多因素回归模型回顾性分析各危险因素的分布。发现医院感染率为 34 2 %,其中呼吸道感染占 6 9 7%。单因素分析危险因素为 2 4小时每公斤体重尿蛋白定量 (尿蛋白 )、住院时间、激素使用时间、抗生素使用种数及时间。多因素分析危险因素为尿蛋白、使用抗生素种数及时间。提出加强呼吸道疾病管理 ,建立洁净病房 ,合理使用抗生素是降低医院感染率的重要措施。尿蛋白定量是肾病医院感染的灵敏指标 ,肾病确诊后应足量足疗程使用肾上腺皮质激素 。

To find out the risk factors of hospital infection in childhood primary nephrotic syndrome(nephrosis) and prophylactico therapeutic measures, 190 cases of child patients hospitalized for nephrosis during the period lasting from 1991 to 1999 were collected. Then a retrospective analysis of the distribution of the various risk factors was made using the single factor analysis and the logistic multi factor regression model. The hospital infection rate was found to be 34.2%, with respiratory infection accounting for 69.7%. The single factor analysis indicated that the risk factors included quantity of urinary protein per kilogram of weight within 24 hours(urinary protein), length of stay, length of hormone usage, entities of antibiotics used and length of such usage. The multi factor analysis indicated that the risk factors included urinary protein, entities of antibiotics used and length of such usage. The authors present the view that strengthening the control of respiratory diseases, setting up clean wards, and ensuring the rational use of antibiotics are some of the key measures for reducing the rate of hospital infection. The quantity of urinary protein is a sensitive index of hospital infection in nephrosis. Once diagnosis of nephrosis has been confirmed, it is necessary to use ACH in full dose and for a complete course of treatment so as to reduce the loss of protein from the urine as soon as possible.