精神科老年患者医院感染分析及预防

Risk factors for nosocomial infections in elderly patients of psychiatric department and prevention countermeasures

目的探讨精神科老年患者医院感染的危险因素,制定预防措施,为控制医院感染提供依据。方法回顾性调查分析医院精神科2011年6月-2012年6月(干预前)1 024例住院的老年患者和2012年6月-2013年6月(干预后)1 056例住院的老年患者临床资料,采用对照的方法比较干预前后老年患者医院感染率。结果干预前1 024例老年患者发生医院感染97例,感染率为9.47%,干预后1 056例老年患者中有63例发生医院感染,感染率为5.97%;干预前感染部位依次为呼吸道、泌尿道、胃肠道及皮肤软组织损伤,分别占69.07%、13.40%、13.40%、4.13%,干预后感染部位依次为呼吸道、胃肠道、泌尿道及皮肤软组织损伤,分别占65.08%、17.46%、12.70%、4.76%,差异有统计学意义(P<0.01)。结论精神科老年患者医院感染与长期卧床、抵抗力下降、基础疾病较多、生活自理能力差等因素有关,因此加强病房医院感染控制和基础护理工作,严格执行无菌技术操作,进行早期干预,降低医院感染的发生率。

OBJECTIVE To explore the risk factors for nosocomial infections in the elderly patients of psychiatric department and put forward the prevention measures so as to provide guidance for control of nosocomial infections . METHODS A total of 1024 elderly patients who were hospitalized from Jun 2011 to Jun 2012 （before the interven‐tion） and 1056 elderly patients who were hospitalized from Jun 2012 to Jun 2013 （after the intervention） were en‐rolled in the study ,the clinical data of the elderly patients were retrospectively analyzed ;a case‐control study was conducted to compare the incidence of nosocomial infections before and after the intervention .RESULTS The noso‐comial infections occurred in 97 of 1024 elderly patients before the intervention ,with the infection rate of 9 .47% ;the nosocomial infections occurred in 63 of 1056 elderly patients after the intervention ,with the infection rate of 5 .97% .Before the intervention ,the elderly patients with respiratory tract infections accounted for 69 .07% ,the elderly patients with urinary tract infections 13 .40% ,the elderly patients with gastrointestinal tract infections 13 .40% ,the elderly patients with skin and soft tissue infections 4 .13% ;after the intervention ,the elderly pa‐tients with respiratory tract infections accounted for 65 .08% ,the elderly patients with gastrointestinal tract infec‐tions 17 .46% ,the elderly patients with urinary tract infections 12 .70% ,the elderly patients with skin and soft tissue damage 4 .76% ,the differences were significant （P＆lt; 0 .01） .CONCLUSION The incidence of nosocomial infections in the elderly patients of psychiatric department is associated with the long‐term bedridden ,decreased immunity ,and complication of multiple underlying diseases as well as poor daily living ability ,therefore ,it is nec‐essary to strengthen the control of nosocomial infections in the ward as well as the primary nursing ,strictly imple‐ment the aseptic operation ,and carry out the early intervention so as to reduce the incidence of nosocomial infec‐tions .