急诊科重症患者医院感染的危险因素与预防

Clinical research on risk factors and preventions of nosocomial infections in critically ill patients in emergency department

目的探讨导致急诊科重症患者发生医院感染的危险因素,并根据危险因素提出有效的预防措施。方法选择医院2012年1月-2014年12月急诊科收治的800例重症患者,分析所有患者的临床资料,包括:患者感染部位、住院时间、基础疾病、侵入性操作等,并进行多因素logistic回归分析,数据采用SPSS 19.0软件进行统计分析。结果共114例患者发生医院感染,感染率为14.25%,以呼吸道感染为主占47.37%;对患者的资料进行多因素logistic回归分析显示,年龄≥60岁、住院时间>1周、有侵入性操作、抗菌药物广泛使用、病变部位较多及患有基础疾病为发生医院感染的独立危险因素(P<0.05)。结论为预防感染的发生,应减少对患者的侵入性操作,控制基础疾病,诊治过程中严格执行无菌理念,合理使用抗菌药物,做好病房环境的消毒工作等。

OBJECTIVE To explore risk factors of nosocomial infections in critically patients in emergency department,and to put forward effective preventive measures according to these risk factors.METHODS A total of 800 critically patients admitted to our hospital emergency department from Dec.2014 to Jan.2012 were enrolled in this study.Clinical data,including sites of infections,inpatient time,underlying disorders,invasive operations,etc.,were analyzed.Multiple logistic regression analysis was performed and data were analyzed with SPSS 19.0.RESULTS A total of 114 patients suffered from nosocomial infections,and infection rate was 14.25%.Among those infections,respiratory tract infections accounted for 47.37%.According to multiple logisticregression analysis,patients aged 60 years and older,inpatient time longer than a week,invasive operation,abuse of antibiotics,multiple lesions,and underlying disorders were independent risk factors of nosocomial infections（P〈0.05）.CONCLUSIONIn order to prevent infections,it is suggested to reduce invasive operation,control underlying diseases,implement aseptic concept strictly,use antimicrobial agents rationally,and disinfect wards,etc.