极低出生体质量儿急性上呼吸道感染的相关因素分析及护理对策

Related factors analysis and nursing countermeasures of acute upper respiratory infection in very low birth weight infant

目的分析极低出生体质量儿急性上呼吸道感染的相关因素,提出针对性的护理对策。方法选择我院2010年1月～2012年6月并发急性上呼吸道感染的极低出生体质量儿42例作为上呼吸道感染组,同时选择同期66例未发生急性上呼吸道感染的极低出生体质量儿作为非感染组,对两组相关指标进行分析。结果出生时体质低、胎龄小、平均机械通气时间长、平均住院时间长、抗生素应用、胎膜早破、重症监护、基础疾病等因素是低出生体质量儿上呼吸道感染的主要因素(P<0.05)。感染的病原菌以G-球菌为主,26株,占61.90%;前三位的病原菌分别为肺炎克雷伯菌、鲍曼不动杆菌、大肠埃希菌,分别占21.43%、16.67%、11.90%;G+球菌16株,占38.10%,前三位的病原菌分别为表皮葡萄球菌、肺炎链球菌、金黄色葡萄球菌,分别占11.90%、9.52%、9.52%。结论极低出生体质量儿并发急性上呼吸道感染的因素众多,出生时体质低、基础疾病、胎龄小是不可更改因素,其他因素可通过针对性的护理加以避免,以降低极低出生体质量儿的感染发生率。

Objective To analyze related factors of acute upper respiratory infection in very low birth weight infant and propose targeted nursing countermeasures. Methods Fortytwo very low birth weight infant with acute upper respiratory infection admitted to our hospital from January 2010 to June 2012 were selected as the upper respiratory infection group while 66 very low birth weight children without acute upper respiratory infection in the same period were selected as the noninfection group. Relevant indicators of the two groups were analyzed. Results Low birth physique, small gestationl age, long average length of mechanical ventilation, long average length of hospital stay, antibiotics applica tion, premature rupture of fetal membranes, intensive care and underlying diseases were the major factors of acute up per respiratory infection in very low birth weight infant （P〈0.05）. The main pathogenic bacteria were G cocci, of which the number of strains 26, accounting for 61.90%; The top three pathogenic bacteria were Klebsiella pneumoniae, Acinetobacter baumannii and Escherichia coli, accounting for 21.43%, 16.67% and 11.90% respectively. There were 16 strains of G cocci, accounting for 38.10%; The top three pathogenic bacteria were Staphylococcus epidermidis, Strepto coccus pneumoniae and Staphylococcus aureus bacteria, accounting for 11.90%, 9.52% and 9.52%. Conclusion There are numerous factors of acute upper respiratory infection in very low birth weight infant. Low physique, underlying dis eases and small gestational age are unchangeable factors while other factors can be avoided through specific nursing, thus reducing the infection rate of very low birth weight children.