NICU早产儿医院感染的影响因素

NICU preterm children influencing factors of nosocomial infections

目的分析新生儿重症监护病房(NICU)早产儿医院感染的原因、治疗方法,以期提高临床对NICU早产儿医院感染的认识,提高治疗水平。方法回顾性分析医院2012年3月-2013年3月NICU213例早产儿临床资料,其中发生医院感染早产儿37例设为感染组,未发生医院感染的176例早产儿为对照组,分析感染的原因、主要病原菌及感染的影响因素,数据采用SPSS13.0软件进行统计处理。结果 37例早产儿发生的感染部位依次为呼吸道、血液及皮肤黏膜、胃肠道和其他部位,感染组胎龄<32周、低体质量儿、入住NICR时间长、机械通气时间长、肠外营养、留置胃管、胎膜早破的发生率明显高于对照组,以上因素差异有统计学意义(P<0.05);医院感染主要的病原菌是革兰阴性菌占48.72%、革兰阳性菌占30.77%、真菌占20.51%。结论 NICU早产儿发生医院感染的因素众多,临床表现多样而缺乏特异性,因此,对于感染的高危早产儿应采取必要的预防性干预措施,降低感染的发生率。

OBJECTIVE To analyze the causes of nosocomial infections in preterm children in neonatal intensive care unit（NICU）and treatment methods,so as to provide more understanding for preterm children with nosocomial infections and improve the level of treatment.METHODS A total of 213 preterm children cases were retrospectively analyzed in our hospital from Mar.2012 to Mar.2013 in NICU,including 37 cases with nosocomial infections as infection group and 176 cases without nosocomical infections as control group,analyzing the reasons,main pathogenic bacteria and infectious factors.SPSS1.30 software was used for statistical analysis.RESULTS The infection sites for the 37 cases of infections in preterm children in rank order were respiratory infections,respectively,blood and skin and mucous membrane infections,gastrointestinal infections and other infections.Gestational age32weeks,low birth weight children,stay NICR long time,mechanical ventilation for a long time,parenteral nutrition,indwelling stomach tube,incidence of premature rupture of membranes,infection group was significantly higher than control group（P0.05）.The major pathogen causing infection was G-cocci,accounting for 48.72%,G＋cocci accounting for 30.77%,fungi accounting for 20.51%.CONCLUSION NICU nosocomial infections in preterm infants are affected by many factors,with various clinical manifestations and lack of specificity,therefore,at high risk of infection in preterm children,the necessary preventive interventions should be taken to reduce the incidence of infections.