血液风湿科患者医院感染率的变化分析

Changes of nosocomial infection rate in patients with hematological or rheumatic diseases

目的分析血液风湿病科患者医院感染情况,探讨医院搬迁后通过改善消毒隔离措施对医院感染率的影响,为降低血液风湿科医院感染率提供依据。方法对医院2007-2008年搬迁前两年1163例及2009-2010年搬迁后两年1563例血液风湿病科住院患者的感染部位及医院感染率进行回顾性调查,记录感染部位、感染例次,统计感染率。结果搬迁前两年收治的血液风湿性疾病共832例,占71.54%,非血液风湿病为331例,占28.46%,其医院感染率为9.90%;搬迁后两年收治的血液风湿性疾病共1169例,占74.79%,非血液风湿病为394例,占25.21%,其医院感染率为7.06%;搬迁后血液风湿科患者的医院感染率明显下降,差异有统计学意义(χ2=14.55,P<0.01);搬迁前后患者主要感染部位差异无统计学意义,以呼吸道感染最多,在感染部位构成中占65.00%,其次为口腔及胃肠道感染,但搬迁后呼吸道及胃肠道感染均较搬迁前明显下降。结论医院搬迁后通过改善执行手卫生的条件、提高手卫生依从性,提高病房空气质量,合理配置病床等措施可显著降低血液风湿患者的医院感染率。

OBJECTIVE To investigate the distribution of nosocomial infections in patients with hematological or rheumatic diseases, explore the effect of hospital removal for nosocomial infection rate by improving measures of hospital disinfection and isolation, and to provide basis for reducing nosocomial infections in the hematological and rheumatic department. METHODS A retrospective investigation was conducted on 1163 inpatients with hematolog- ical or rheumatic diseases in two years before removal and 1563 inpatients in two years after removal, with the nosocomial infection sites and case times recorded and infection rates calculated. RESULTS There were 832 cases （71.54%） of blood rheumatism, and 331 cases （28.46%） of non-blood rheumatism in the hospital in two years before removal, and the nosocomial infection rate was 9.90%; after two years of hospiial removal, patients with blood and non-blood rheumatism were 1169 （74.79 %） and 394 （25.21%） respectively, and the nosocomial infec-tion rate was 7.06 %, which was significantly reduced and the difference had statistical significance （X^2= 14.55, P 〈0. 001）. The difference of main infection sites had no statistical significance, most of which was respiratory tract infection （65.00 %）, the secondary were the oral cavity and gastrointestinal infections, but the infections in respir-atory tract and gastrointestinal were significantly lower than those of pre-removal. CONCLUSION With the imple-mentation of these measures including optimizing hand hygiene facilities and compliance, improving the air quality of the wards and rational bed allocation, the nosocomiaI infection rate of patients with hematological or rheumatic diseases is significantly reduced.