职业性慢性苯中毒患者医院感染危险因素的调查

Nosocomial infection and relevant risk factors of patients with occupational chronic Benzene poisoning

目的：探讨引起职业性慢性苯中毒患者医院感染的危险因素,为有效做好慢性苯中毒患者的医院感染控制与管理工作提供理论依据。方法对深圳市职业病防治院职业病科2006年7月—2014年6月收治的222例慢性苯中毒病例进行回顾性调查,其中63例为医院感染组,159例无任何感染者为非医院感染组,对两组资料进行单因素分析后,进行非条件Logistic二元回归分析。结果8年共发生医院感染63例,医院感染的发生率为28.37%,感染例次数为87,例次发病率为39.19%；感染部位以呼吸道为主,占42.53%。多因素分析得出差异有统计学意义的因素有6项,分别为：外周血白细胞计数（OR=1.515,P〈0.01,95%CI：1.419～1.618）、中性粒细胞（OR =0.006,P 〈0.01,95%CI：0.002～0．014）、血小板（OR=0.891,P〈0.01,95%CI：0.862～0.921）、诊断分级（OR=1.271,P〈0.01,95%CI：1．208～1.338）、住院时间（OR=5.907,P〈0.01,95%CI：5.645～6.181）和文化程度（OR=0.532,P〈0．01,95%CI：0.480～0.589）。结论慢性苯中毒患者医院感染率高,住院时间、外周血白细胞计数、诊断分级是慢性苯中毒发生医院感染的独立危险因素,中性粒细胞、文化程度、血小板为其保护性因素。

Objective To study the risk factors that lead to nosocomial infection of occupational chronic Benzene poisoning patients, and can provide theoretical foundation for infection control and management of occupational chronic Benzene poisoning patients. Methods A retrospective review was made among 222 cases of chronic Benzene poisoning patients who were hospitalized in Occupational Diseases Department in Shenzhen Prevertion and Treatment Center for Occupational Disease during the period between July 2006 and June 2014. A total of 63 cases were nosocomial infection group while 159 cases were non-infected group, and the patients of two groups were analyzed by single factor analysis and logistic repression analysis. Results There were 63 nosocomial infection cases during 8 years that the rate of nosocomial infection was 28. 37%. There were 87 infection samples with the rate 39. 19%;the most common infection site was respiratory tract accounting for 42. 53%. After logistic repression analysis, we obtained 6 risk factors which differences were statistically significant including WBC count （OR=1. 515,P〈0. 01,95%CI：1. 419-1. 618）, neutrophil （OR=0. 006,P〈0. 01,95%CI：0. 002-0. 014）, soterocyte （OR=0. 891,P〈0. 01,95%CI：0. 862-0. 921）, diagnosis grading （OR=1. 271,P〈0. 01,95%CI：1. 208-1. 338）, length of stay （OR=5. 907,P〈0. 01,95%CI：5. 645-6. 181） and education degree （OR = 0. 532,P 〈 0. 01,95% CI：0. 480-0. 589）. Conclusions Chronic Benzene poisoning has a high nosocomial infection rate, and the length of hospitalization, WBC count and diagnosis grading, that all are independent risk factors of nosocomial infection for chronic Benzene poisoning patients while neutrophil, education degree and soterocyte are protective factors.