肺癌住院患者实施医院感染预防措施的效果分析

Effect of prevention measures on prevention of nosocomial infections in hospitalized patients with lung cancer

目的分析肺癌住院患者医院感染的危险因素,评价感染预防措施对医院感染的预防效果。方法回顾性分析医院2011年1月-2013年3月收治的329例肺癌患者临床资料,分析患者住院期间医院感染情况及危险因素,制定感染预防措施,另选取肺癌患者172例随机分为观察组和对照组,各86例,观察组实施感染预防措施,对照组仅作一般护理,评价预防效果。结果 329例患者发生医院感染45例,医院感染率为13.7%;观察组患者医院感染率为4.7%,显著低于对照组的14.0%,两组比较差异有统计学意义(χ2=5.583,P<0.05);经单因素logistic回归分析,患者年龄、卡氏功能状态(KPS)评分、肿瘤淋巴结转移(TNM)分期、合并糖尿病及慢性阻塞性肺疾病、住院时间、侵入性操作、白细胞计数、预防性应用抗菌药物9个变量与医院感染相关(P<0.05)。结论年龄≥60岁、KPS评分≤70分、合并糖尿病、合并COPD、住院时间>2周、预防性应用抗菌药物是医院感染独立危险因素,针对以上危险因素进行相应的干预能有效降低医院感染率。

OBJECTIVE To analyze the risk factors for nosocomial infections in the hospitalized patients with lung cancer and evaluate the effect of prevention measures on prevention of the nosocomial infections. METHODS The clinical data of 329 lung cancer patients who were hospitalized from Jan 2011 to Mar 2013 were retrospectively analyzed, then the risk factors for the nosocomial infections during the hospital stay were analyzed, the prevention measures were formulated; meanwhile, 172 patients with lung cancer were recruited and randomly divided into the observation group and the control group, with 86 cases in each; the prevention measures were carried out in the observation group, the conventional nursing was implemented in the control group, and the effect on prevention of the infections was evaluated. RESULTS Of the 329 patients, the nosocomial infections occurred in 45 cases with the incidence rate of I3.7% the incidence of nosocomia[ infections was 4.7% in the observation group, significantly lower than 14.0% in the control group（x^2 =5. 583,P〈0.05）. The univariate logistic regression analysis indicated that the incidence of nosocornial infections was associated with the age, karnofsky functional status （KPS） score, lymph node metastasis staging, complication of diabetes or chronic obstructive pulmonary disease （COPD）, length of hospital stay, invasive operation, white blood ceils counts, and antibiotics prophylaxis （P 〈0.05）. CONCLUSION The no less than 60 years of age, KPS score no more than 70 points, complication of diabetes, complication of COPD, length of hospital stay more than 2 weeks, and antibiotics prophylaxis are the independent risk factors for the nosocomial infections, It is an effective way to take corresponding interventions to such risk factors so as to reduce the incidence of nosocomial infections.