老年呼吸机相关肺炎感染的临床预防与控制研究

Study on the Prevention and Control of Ventilator-Associated Pneumonia Infection in Elderly People

目的探讨老年呼吸机相关肺炎感染的临床预防与控制情况。方法选取2010年1月至2013年2月四平市中心人民医院感染科90例老年呼吸机相关肺炎感染患者为研究对象,按随机数字表法分成两组,对照组45例,仅进行常规的抗感染治疗,观察组45例,在对照组的基础上加以防控,比较两组治疗后的临床效果。结果对照组经治疗后3 d内感染控制者9例(20.0%),1周内感染控制19例(42.2%);观察组3 d内感染控制21例(46.7%),1周内感染控制16例(35.6%)。两组比较差异有统计学意义(P<0.05);对照组患者对治疗的满意度为73.3%,依从度为73.3%;观察组患者对治疗的满意度为100%,依从度为93.3%。两组比较差异有统计学意义(P<0.05)。观察组患者的住院时间为(17±7)d、生活质量评分为(91±8)分、侵袭性操作率为8.9%、其他部位感染率为2.2%、机械通气时间(3.7±2.1)d、病死率为6.7%、平均医疗费用(7473±2738)元,而对照组的住院时间为(32±10)d、生活质量评分为(47±10)分、侵袭性操作率为26.7%、其他部位感染率为15.6%、机械通气时间(6.4±3.4)d、病死率15.6%、平均医疗费用(13842±5273)元。两组上述指标比较差异均有统计学意义(均P<0.05)。结论加强老年呼吸机相关肺炎感染的临床预防与控制,有助于降低医院感染,提高临床效果。

Objective To explore the prevention and control condition of ventilator-associated pneumonia infection in elderly people. Methods A total of 90 elderly patients with ventilator-associated pneumonia infection admitted to Siping Central People＇s Hospital from Jan. 2010 to Feb. 2013 were selected,and divided into two groups,with 45 cases in each group： patients in control group received only conventional anti-infection treatment,while patients in observation group received intensive prevention and control on the basis of conventional treatment,the clinical effects of the two groups were observed after treatment. Results In the control group,9 cases got infection controlled within 3 d after treatment（ 20. 0%）,19 cases got infection controlled within 1 week after treatment（ 42. 2%）; in the observation group,21 cases got infection controlled within 3 d after treatment（ 46. 7%）,16 cases got infection controlled within 1 week after treatment（ 35. 6%）. Difference of the two groups was statistically significant（ P 0. 05）. Satisfaction degree of the control group was 73. 3%,and compliance degree was 73. 3%; satisfaction degree of the observation group was 100%,compliance degree was 93. 3%. The difference was statistically significant（ P 0. 05）. In the control group,hospitalization time was（ 17 ± 7） d,quality of life score was（ 91 ± 8） points,invasive operation rate was 8. 9%,infection rate of other parts was 2. 2%,duration of mechanical ventilation was（ 3. 7 ±2. 1） d,mortality rate was 3（ 6. 7%） and the average medical costs was（ 7473 ± 2738） million; while in the control group,hospitalization time was（ 32 ± 10） d,quality of life score was（ 47 ± 10） points,invasive operation rate was 12（ 26. 7%）,infection rate of other parts was 7（ 15. 6%）,duration of mechanical ventilation was（ 6. 4 ± 3. 4） d,mortality rate was 15. 6% and the average medical costs was（ 13842 ± 5273） yuan,the differences were statistically significant（ P 0. 05）. Conclusion Enhancing the prevention and control of ventilator-associated pneumonia infections in elderly people can reduce the hospital infection rate and improve clinical effect.