心内科住院患者医院感染发生危险因素及预防对策

Risk Factors and Treatment of Nosocomial Infection in Cardiology Department

目的探讨心内科住院患者合并医院感染的临床特征和相关危险因素,以采取有针对性诊疗措施,为临床有效防止医院感染的发生提供科学依据。方法对自2010年1月至2012年12月在深圳市龙岗中心医院心内科住院治疗的1573例患者的临床资料进行分析,探讨医院感染发生的危险因素。结果所有患者有93例发生医院感染,感染发生率为5.91%;心内科医院感染的常见部位是呼吸道38例(40.86%)、泌尿道25例(26.88%),消化道13例(13.98%)和皮肤11例(11.83%)等;通过对心内科住院患者进行单因素χ2检验分析,医院感染与年龄、病程、血清白蛋白水平、侵入性操作、住院时间、预防性应用抗菌药物、心功能分级以及合并基础疾病有相关性,Logistic多因素回归分析发现年龄(OR=2.612,P=0.014)、心功能分级(OR=2.128,P=0.013)、侵入性操作(OR=2.051,P=0.022)和预防性应用抗菌药物(OR=2.607,P=0.015)是医院感染发生的独立危险因素。结论心内科患者医院感染的发生与多种因素相关,应当密切监测高龄患者,减少侵入性操作,治疗原发疾病,合理应用抗菌药物,采取有针对性的诊疗措施,降低医院感染的发生。

Objective To explore the state of nosocomical infection and its risk factors in cardiology de partment in order to provide scientific basis for the effective prevention and treatment. Methods Retrospective analysis on the risk factors of nosocomial infection in 1573 patients in Cardiology Department of Longgang Central Hospital from Jan. 2010 to Dec. 2012 was done, and the risk factors for nosocomial infection were dis cussed. Results Among all patients,93 patients had nosocomial infection, the infection rate was 5.91%. The main infection sites were：respiratory tract 38 cases（40.86% ）, urinary tract 25 cases（26.88% ） ,diges- tive tract 13 eases （ 13.98% ） and skin tissue 11 cases（ 11.83 % ） ; the nosocomial infection in cardiology de- partment were closely associated with age, course of disease, hypoproteinemia, invasive manipulation, days of hospitalization, antibiotic prophylaxis, heart function grade and combination with other diseases through single-factorx2 analysis,and after Logistic regression analysis,it was found that age（ OR =2. 612,P =0. 014） ,heart function grade （ OR = 2.128, P = 0.013 ） , invasive manipulation （ OR = 2.051, P = 0. 022 ） and antibiotic prophylaxis（ OR = 2. 607, P = 0. 015 ） were the independent risk factors causing nosocomical infection. Conclusion The nosocomial infection of inpafients in cardiology deparlment are associated with many factors, the elderly patients should be closely monitored, the invasive operation should be reduced, the primary disease should be treated, antibiotics should be rationally used, and pen ＇ diagnosis and treatment measures should be taken to reduce the incidence of nosocomial infection.