2型糖尿病患者医院感染的影响因素分析

Analysis of influencing factors for type 2 diabetic patients with nosocomial infections

目的探讨2型糖尿病患者医院感染发生率、部位分布及发生医院感染的影响因素,为制定预防控制措施提供依据。方法回顾性分析2008年1月-2013年5月210例患者临床资料,使用自制的2型糖尿病患者医院感染调查表,由经过培训的专科护士进行数据收集,对影响因素进行单因素分析,以是否发生医院感染为因变量,对有统计学意义的因素再进行非条件logistic多元回归分析,统计描述与分析由SPSS17.0软件完成。结果210例2型糖尿病患者发生医院感染28例,感染率13.3%;主要感染部位为呼吸道及泌尿道,分别占42.9%和25.0%;经单因素分析发现,年龄≥60岁、空腹血糖≥10.0mmol/L、住院时间≥2周,服用过抗菌药物以及进行侵入性操作的患者,更容易发生医院感染,差异有统计学意义(P<0.05);经非条件logistic分析,患者年龄、空腹血糖、住院天数及侵入性操作是2型糖尿病患者发生医院感染的最主要影响因素,差异有统计学意义(P<0.01)。结论 2型糖尿病患者医院感染率较高,对于老年患者住院期间,尽量减少各种侵入性操作,缩短住院时间,日常监测血糖,可有效降低医院感染率,提高患者生活质量。

OBJECTIVE To know the incidence rate ,parts of the distribution and influencing factors of type 2 diabetic patients with nosocomial infections in order to explore the probable influence factors and offer the basis for making preventive measures . METHODS From Jan . 2008 to May 2013 , 210 patients′ clinical data were retrospectively analyzed .Using a homemade ＂hospital infection in patients with type 2 diabetes questionnaires＂, the trained endocrinology nurses were in charge for data collection .Firstly ,single factor was analyzed .Making the nosocomial infection as dependent variable , the factors with statistical significance were analyzed by unconditioned logistic multivariate regression analysis .All statistical description and analysis was conducted by SPSS 17 .0 .RESULTS Among 210 cases of type 2 diabetic patients ,28 cases got nosocomial infections ,accounting for 13 .33% . The main parts were respiratory and urinary tract （42 .86% and 25 .00% ） . After chi-square analysis ,we found that the person aged more than 60 years ,fasting blood sugar over 10 .0 mmol/L ,hospital stays over 2w ,took antibacterial agents and invasive procedure before were more likely to be infected .The difference was significant （P〈 0 .05） .After unconditioned logistic multivariate regression analysis ,patients age ,fasting blood-glucose ,length of stay and invasive procedure were the main influence factor to them .The difference was significant （P〈0 .01） .CONCLUSIONS The nosocomial infection rate of type 2 diabetic patients was high in my hospital .In order to decrease the nosocomial infection rate ,we should pay more attention to the elder people and try our best to reduce the invasive procedure ,shorten the length of stay and ask them to monitor their blood glucose everyday ,which could help reduce the infection rate and improve the life quality for patients .