手足口病重症患儿医院感染的干预措施分析

Interventions in children with severe HFMD hospital infections

目的分析手足口病患儿医院感染的特点及相关危险因素,探讨手足口病重症患儿医院感染的相关因素及提出针对性的预防对策,为治疗重症手足口病患儿提供科学依据。方法选取2012年12月-2014年12月医院接收治疗564例手足口病重症患儿为研究对象,统计患儿的感染部位,分析重症患儿的年龄、合并并发症、是否使用呼吸机、是否留置胃管、使用激素、是否联用多种抗菌药物及住院时间等与发生医院感染的相关性,探讨其干预措施。结果 564例重症手足口病患儿发生医院感染46例,感染率8.16%;重症患儿发生医院感染主要以呼吸道感染为主占41.3%,其次为消化系统感染,占34.8%;低龄、合并并发症、使用呼吸机、留置胃管、侵入性操作、使用激素及联合多种抗菌药物治疗的患儿感染率均明显较高,分别为24.6%、24.0%、20.0%、23.2%、16.1%、11.7%及14.8%,住院时间过长导致接触病原菌较多易引发感染。结论临床治疗手足口病患儿时,对于重症患儿应及早发现早治疗,缩短住院时间,减少侵入性操作,合理使用抗菌药物,实施优化护理干预,能积极有效的控制医院感染。

OBJECTIVE To analyze the characteristics and risk factors of hand-foot-and-mouth disease（HFMD）in children hospital infections,and discuss the correlation factors of HFMD children with severe hospital infections and propose specific preventive measures for the treatment,so as to provide a scientific basis for the treatment of HFMD children.METHODS A total of 564 cases of children with HFMD got treatment in our hospital from Dec.2012 to Dec.2014 were selected for this study.Age of children,the complication,whether to use the breathing machine,whether indwelling stomach tube,use of hormones,whether or not combined with a variety of antibiotics and hospitalization time were all under analysis to understand the correlation between them and hospital infections and discuss the interventions.RESULTS There were 46 cases of children with hospital infections among 564 cases of children with HFMD,infection rate 8.16%.Most of the infection was respiratory infections accounted for41.3%,followed by digestive infection,accounting for 34.8%.Children in low age,with complications,using breathing machine,whether indwelling stomach tube,invasive procedure,using hormones,combined with a variety of antibiotics had infection rate significantly higher,accounting for 24.6%,24.0%,20.0%,23.2%,16.1%,11.7% and 14.8%.Prolonged hospitalization led to contact with more pathogens which easily to got infections.CONCLUSION About the treatment,children with severe HFMD should get early notice and treatment,with shorter hospitalization time,and less invasive procedures.Rational use of antibiotics and the implementation of optimization nursing intervention can control hospital infections positively and effectively.