肝胆外科患者多重耐药菌感染的预防及护理对策

Analysis and nursing strategy of multiple resistant bacteria of patients in department of hepotabiliry surgery

目的分析肝胆外科住院患者多重耐药菌感染情况并提出预防及护理防施。方法对2010-2012年肝胆外科出现多重耐药菌的62例住院患者进行全程追踪调查,收集患者一般资料、病原菌的种类、感染部位、标本类型进行分析。结果患者的胆汁、腹腔引流液、血液分离病原菌以大肠埃希菌和肺炎克雷伯菌多见,针对患者实施消毒隔离、手卫生培训、卫生环境管理、医疗废物处理、严格遵守无菌技术操作规程等综合护理干预措施后,62例患者中61例康复出院,仅1例因呼吸衰竭死亡。结论强化感染监测,严格执行消毒隔离、标准预防及手卫生规范,能预防交叉感染的发生,提高感染控制效果,促进患者康复。

Objective To analysis the infection of MRB in Department of Hepatobiliry surgery and propose prevention stragey and nursing measures. Methods 62 patients infected MRB in our department between 2010 and 2012were enrolled in our study,and analyzed retrospectively. Results The most segregation sample are Bile（23）,Peritoneal fluid（25）and Blood（11）.Colon bacillus（58.1%）,Staphylococcus aureus（24.2%）and Klebsiella pneumoniae（14.5%）are the most common pathogenic bacteria.For patients with implementation of disinfection and isolation measures,hand hygiene training,environmental health management,medical waste treatment,strictly abide by the rules of Aseptic technique on patients with comprehensive nursing intervention,61 cases rehabilitation discharge,only one case died of respiratory failure. Conclusion Strengthen infection monitoring,perform strict implementation of disinfection and isolation,standard precautions and hand hygiene standards,can effectively prevent cross infection,improve infection control effect,and promote the rehabilitation of patients.