住院偏瘫康复治疗患者医院感染控制研究

Prevalence of nosocomial infections in hemiplegia patients hospitalized for rehabilitation

目的调查住院偏瘫康复治疗患者医院感染状况，探讨感染的影响因素，以降低医院感染率。方法前瞻性调查2009年1月-2012年12月80例偏瘫康复治疗住院患者临床资料，使用SPSS17．0统计软件进行分析。结果发生感染共24例、28例次，感染率30．00％、例次感染率35．OO％，以下呼吸道为主，占50．00％；年龄≥60岁、入院时间≤2周、侵入性操作≥10次、瘫痪肢体肌力0～II级以及抗菌药物使用时间≥10d等患者的感染率分别为40．00％、60．86％、51．52％、60．86％、50．00％，与年龄〈60岁13．33％、入院时间〉2周17．54％、侵入性操作〈10次的14．89％、瘫痪肢体肌力Ⅲ～Ⅳ级的7．54％以及抗菌药物使用〈10d 16．67％相比，差异均有统计学意义（P〈0．05）；经多因素分析后，入院时间、侵入性操作次数、瘫痪肢体肌力以及抗菌药物使用时间等，均是患者发生感染的独立危险因素（P〈0．05）。结论下呼吸道是住院偏瘫康复治疗患者发生感染的主要部位，而入院时间、侵人性操作次数、瘫痪肢体肌力以及抗菌药物使用时间等，是影响感染发生的危险因素。

OBJECTIVE To observe the prevalence of nosocomial infections in the patients with hemiplegia hospitalized for rehabilitation and explore the influencing factors for the infections so as to reduce the infection rates. METHODS A prospective survey was conducted for the clinical data of 80 cases of hemiplegia who were hospitalized for rehabilitation from Jan 2009 to Dec 2012, and the Statistical analysis was performed with the use of SPSS17.0 software. RESULTS The infections occurred in 24 cases （28 case-times） with the infection rate of 30.00% and the case-time infection rate of 35.00%, among which the patients with lower respiratory tract infections accounted for 50.00%. The incidence of nosocomial infections was 40.00% in the patients with more than 60 years of age, 60.86% in the patients with hospitalization duration less than 2 weeks, 51. 52% in the patients with frequency of invasive operation more than 10 times, 60.86% in the patients with paralyzed limb muscle strength ranging from 0 to Ⅱ grade, 50.00% in the patients with duration of use of antibiotics more than 10 days, as compared with the patients with less than 60 years of age （13.33 %）, the patients with hospitalization duration more than two weeks, the patients with frequency of invasive operation less than 10 times （14. 89%）, the patients with paralyzed limb muscle strength ranging from Ⅲ to Ⅳ grade （7.54%）, and the patients with duration of use of antibiotics less than 10 clays （16.67 %）, the differences were statistically significant （P〈0.05）. The multivariate analysis showed that the hospitalization duration, invasive operation, paralyzed limb muscle strength, and duration of use of antibiotics were the risk factors for the nosocomial infections （P〈0.05）. CONCLUSION The lower respiratory tract is the predominant infection site of the hemiplegia patients hospitalized for rehabilitation; the hospitalization duration, frequency of invasive operation, paralyzed limb muscle strength, and duration of use of antibiotics are the risk factors for the nosocomial infections.