2013年-2016年白血病患者医院感染影响因素分析

Influencing Factors Analysis on the Nosocomial Infection of Leukemia Patients from 2013 to 2016

目的探讨宝鸡市某医院白血病患者医院感染的现状及其影响因素,为临床干预控制医院感染提供理论依据。方法对2013年1月-2016年12月宝鸡市某医院收治的289例白血病患者的病案资料进行回顾性分析,采用病例对照研究,以83例发生医院感染的白血病患者为病例组,同期选取83例未发生医院感染的患者为对照组,运用X^2检验和多因素logistic回归分析对医院感染的相关危险因素进行分析。结果白血病患者医院感染部位前三位为上呼吸道、下呼吸道和泌尿系统感染,分别占37.35%、24.10%和16.87%;多因素分析结果显示,住院时间≥20天、中心静脉穿刺次数(PICC)>2次、合并症、侵入性操作是白血病患者发生医院感染的危险因素。结论白血病患者较易发生医院感染,特别是针对住院时间≥20天、中心静脉穿刺次数(PICC)>2次、合并症、侵入性操作的患者,医院应根据以上危险因素制定针对性的预防控制措施,防止医院感染的发生。

Objectives To investigate the current situation and influencing factors of nosocomial infection in leukemia patients in Baoji, and provide theoretical basis for clinical intervention and control of nosocomial infection. Methods A total of 289 cases of patients with leukemia who were admitted to a hospital in Baoji from January 2013 to December 2016 Were enrolled in the case-control study, including 83 patients with nosocomial infection （case group）. At the same time, 89 cases of patients without nosocomial infection were selected as the control group. The risk factors of nosocomial infection were analyzed by x2 test and multivariate logistic regression analysis. Results The first three sites of nosocomial infection in leukemia patients were upper respiratory tract, lower respiratory tract and urinary tract, accounting for 37.35%, 24. 10% and 16. 87%, respectively. After univariate analysis of paired data of 83 cases, it was found that there were 9 factors related to nosocomial infection, including hospitalization time ≥ 20 days, times of central venous puncture 〉 twice, complications, mvasive operation, courses of chemotherapy ≥ 6 times, non-remission after initial chemotherapy, white blood cell count 〈4 × 10^9/L, neutrophil count 〈 2 × 10^9/L and platelet count 〈 100 ×10^9/L. The muhivariate analysis showed that hospitalization time is larger than 20d, central venous puncture times （PICC） of more than 2 times, complication, invasive operation are risk factors of nosocomial infection in patients with leukemia. Conclusions Patients with leukemia were easy to have nosocomial infection. Especially for patients with hospitalization time ≥ 20 days, times of central venous puncture 〉 twice, complications and invasive operation, targeted preventive and control measures should be made according to the related risk factors to prevent and control the occurrence of nosocomial infection.