恶性消化道肿瘤手术患者医院感染的危险因素分析

Risk factors for nosocomial infections in malignant gastrointestinal cancer patients undergoing surgical procedures

目的对恶性消化道肿瘤手术患者医院感染危险因素进行分析,为控制恶性消化道肿瘤手术患者医院感染发生提供理论依据。方法回顾性分析2000年5月-2013年9月接受手术治疗的980例恶性消化道肿瘤患者的病历资料,分析医院感染发生情况及危险因素,并据此提出相应的有效干预措施。结果 980例患者中共有76例发生医院感染,发生率为7.8%;共分离出病原菌82株,其中革兰阳性菌34株占41.5%,革兰阴性菌32株占39.0%,真菌16株占19.5%;单因素分析结果显示,高龄、病情严重程度(GCS)评分、免疫功能、用药天数及住院天数与医院感染的发生具有相关性(P<0.05),进一步行多因素回归分析,结果显示,高龄、GCS评分≥7分、免疫功能低下和住院天数是医院感染发生的独立危险因素。结论恶性消化道肿瘤患者发生医院感染的风险与高龄、GCS评分≥7分、免疫功能低下及住院天数等因素具有相关性;医院应该提升管理质量,采取综合性措施控制医院感染的发生,保障患者生命安全。

OBJECTIVE To analyze the risk factors for nosocomial infections in the malignant gastrointestinal cancer patients undergoing surgical procedures so as to provide theoretical basis for control of the nosocomial infections in the malignant gastrointestinal cancer patients .METHODS The medical records of 980 malignant gastrointestinal cancer patients who received surgical procedures from May 2000 to Sep 2013 were retrospectively analyzed ,then the incidence of nosocomial infections and risk factors were analyzed ,and the effective interventions were put for‐ward .RESULTS The nosocomial infections occurred in 76 of 980 patients ,with the incidence rate of 7 .8% .A total of 82 strains of pathogens have been isolated , including 34 （41 .5% ） strains of gram‐positive bacteria , 32 （39 .0% ） strains of gram‐negative bacteria ,and 16 （19 .5% ） strains of fungi .The univariate analysis indicated that the incidence of nosocomial infections was associated with the advanced age ,disease severity score ,immune function ,medication duration ,and length of hospital stay （P〈0 .05）;the multivariate regression analysis further showed that the advanced age ,GCS score no less than 7 points ,low immune function ,and length of hospital stay were the independent risk factors for the nosocomial infections .CONCLUSION The incidence of nosocomial infec‐tions is associated with the advanced age ,GCS score no less than 7 points ,low immune function ,and length of hospital stay .It is necessary for the hospital to improve the management quality and take comprehensive control measures so as to ensure the safety of life of the patients .