新疆地区医院消化内镜医源性感染的调查研究

Survey of endoscope-associated iatrogenic infections in Xinjiang area

目的探讨新疆地区医院消化内镜医源性感染的危险因素,并提出相应的预防对策,以降低感染率。方法选取医院收治的行消化内镜检查和治疗的患者4 728例,按照是否发生医院感染将其分为感染组和未感染组,对其临床资料进行回顾性分析。结果 4 728例患者中发生医院感染142例,感染率为3.00%,其中呼吸道感染59例占41.55%、消化道感染83例占58.45%;发生医源性感染的患者年龄≥60岁、合并糖尿病、合并慢性呼吸系统疾病,管腔采用普通流动水进行冲洗、未对零部件进行拆卸冲洗、未严格配置酶溶液、浸泡时间不足、酶洗液重复使用等是感染的危险因素,与未感染组患者比较差异有统计学意义(P<0.05),经logistic回归分析,上述因素中除未严格配制酶溶液外均是造成消化内镜医院感染的独立危险因素(P<0.05);而两组患者的性别、是否合并高血压以及是否进行质量控制差异无统计学意义。结论医院消化内镜医源性感染与多种因素均密切相关,针对这些危险因素给予相应干预,可以达到降低感染的目的。

OBJECTIVE To explore the risk factors for endoscope-associated iatrogenic infections in Xinjiang area and put forward corresponding prevention measures so as to reduce the infection rate.METHODS A total of 4 728patients who underwent the gastrointestinal endoscopy in the hospital were enrolled in the study and divided into the infection group and the non-infection group,then the clinical data of the recruited patients were retrospectively analyzed.RESULTS Of the 4 728patients,the nosocomial infections occurred in 142cases with the infection rate of3.00%,among whom there were 59（41.55%）cases of respiratory tract infections and 83（58.45%）cases of gastrointestinal tract infections.The no less than 60years of age,complication of diabetes,complication of chronic respiratory disease,flushing of lumen with common running water,not performing disassemble flushing,no strict configuration of enzyme solution,insufficient soaking time,and repeated use of enzyme detergent were the risk factors for the iatrogenic infections,as compared with the patients in the non-infection group,the differences were significant（P〈0.05）.The logistic regression analysis showed that all the above factors were the independent risk factors for the endoscope-associated nosocomial infections except for no strict configuration of enzyme solution（P〈0.05）;however,there was no significant difference in the gender,complication of hypertension,or quality of control between the two groups.CONCLUSION The incidence of endoscope-associated iatrogenic infections is closely related to a variety of factors.It is necessary to take targeted interventions to the risk factors so as to reduce the incidence of infections.