急诊冠状动脉介入治疗患者医院感染的相关因素与预防控制分析

Related factors and prevention control analysis of hospital infectionss in patients with percutaneous coronary intervention treatment

目的分析急诊冠状动脉介入（PCI）治疗患者医院感染的相关危险因素,探讨临床预防控制策略,为临床控制PCI医院感染提供依据。方法选择医院2010年1月-2015年11月PCI治疗患者980例,感染例数32例,采用回顾性研究方法分析感染率、感染部位、病原菌主要类型、并分析性别、年龄、合并基础疾病、心功能分级、穿刺部位、支架植入个数、其他侵入性操作和住院时间等相关感染影响因素。结果 PCI患者感染率为3.27%,感染部位依次为呼吸系统43.75%、泌尿系统25.00%、胃肠道18.75%、穿刺部位12.50%;PCI患者感染病原菌中,革兰阳性菌占58.62%,革兰阴性菌占41.38%;PCI患者患者年龄≥60岁、合并基础性疾病≥3种、心功能分级（3-4级）、支架植入个数≥2个、侵入性操作及住院时间≥15d的感染率分别为6.74%、7.75%、7.01%、3.99%、7.14%、6.84%,均高于其他患者,差异有统计学意义（P〈0.05）。结论 PCI感染以呼吸系统和泌尿系统感染为主,其感染发生率与多种因素相关,临床积极进行预防控制,减少感染发生率。

OBJECTIVE To analyze the risk factors associated with percutaneous coronary intervention in patients with hospital infection and discuss the clinical prevention and control strategies,so as to provide the basis for clinical control of PCI hospital infections.METHODS A total of 980 patients treated with PCI were selected in the hospital from Jan.2010 to Nov.2015,including 32 infection cases.The infection rate,infection sites,and pathogen types were retrospectively analyzed,and the infection-related factors including genders,age,with chronic diseases,cardiac function classification,puncture sites,the number of stents implanted,other invasive procedures and hospitalization time were analyzed.RESULTS The Infection rate of the patients with PCI was 3.27%.The infection sites were respiratory system 43.75%,urinary system 25.00%,gastrointestinal tract 18.75%,and puncture sites12.50%,respectively.The constituent ratio of the infected pathogens of PCI patients were G＋53.13%,G-37.50% and fungi 9.38%.The infection rates of PCI patients with the age≥60years,basic diseases≥3,NYHA functional classification（3to 4）,the number of stents implanted in ≥2,invasive procedures and hospitalization time≥15dwere 6.74%,7.75%,7.01%,3.99%,7.14%,and 6.84%,respectively,which were significantly higher than other patients（P〈0.05）.CONCLUSION The PCI infection are mainly with respiratory and urinary tract,and its infection rate is related to many factors,so it needs clinical prevention and control to reduce the incidence of infections.