多媒体宣教对心脏手术患者医院感染的预防控制效果

Effect of multimedia technology on prevention and control of nosocomial infections in patients undergoing cardiac surgery

目的探讨多媒体技术对心脏手术患者医院感染的预防效果,为临床应用提供理论依据。方法选择2013年1月-2016年6月在医院行心脏手术患者1 126例;用随机数表法将患者分为研究组和对照组,每组各563例;对照组患者给予常规健康教育,采用口头叮嘱形式,研究组在对照组的基础上给予多媒体技术干预,比较两组患者医院感染发生率和平均住院时间;采用自制调查问卷方式,对手术前后注意事项、感染相关知识、疾病知识等知晓率进行统计;对感染患者的痰液、尿液、血等标本进行细菌培养和鉴定。结果研究组6例患者发生医院感染,感染率为1.07%,对照组27例患者发生医院感染,感染率为4.80%,显著高于研究组,差异有统计学意义(P<0.05),研究组患者感染知识知晓率为95.20%、术前注意事项知晓率为90.23%、术后注意事项知晓率为95.91%,疾病知识知晓率为88.99%,均显著高于对照组(58.08%、68.38%、70.34%、66.43%),两组比较差异有统计学意义(P<0.05);33例感染患者的送检标本中共分离出病原菌46株,其中革兰阴性菌23株,占50.00%,革兰阳性菌19株,占40.43%,真菌4株,占8.70%;对照组平均住院时间(20.39±4.45)d高于研究组(14.34±4.59)d,两组比较差异有统计学意义(P<0.05)。结论多媒体技术能够显著降低心脏手术患者医院感染率,提高患者医院感染相关知识知晓率,降低患者的住院时间,对比常规健康教育具有较好的优越性。

OBJECTIVE To explore the effect of multimedia technology on prevention of nosocomial infections in pa- tients undergoing cardiac surgery so as to provide theoretical basis for clinical application. METHODS A total of 1 126 patients who underwent the cardiac surgery in the hospital from Jan 2013 to Jun 2016 were enrolled in the study and randomly divided into the study group and the control group, with 563 cases in each group. The control group was given conventional health education by means of injunction, while the study group was given multimedia technology intervention on the basis of the control group. The incidence of nosocomial infections and average hospi- talization duration were compared between the two groups of patients; the precautions before and after the surgery and the awareness rates of related knowledge of infection and knowledge of diseases were statistically analyzed by means of self-designed questionnaires; the sputum, urine, and blood specimens that were obtained from the pa- tients with infection were cultured, and the isolated pathogens were identified. RESULTS The incidence of nosoco- mial infections of the control group was 4.80% （27 cases）, significantly higher than 1.07% （6 cases） of the study group （P〈0.05）. The awareness rate of knowledge of infections of the study group was 95.20%, significantly higher than 58.08% of the control group; the awareness rate of preoperative precautions of the study group was 90.23%, significantly higher than 68. 38% of the control group; the awareness rate of postoperative precautions of the study group was 95.91%, significantly higher than 70. 34% of the control group; the awareness rate of knowledge of diseases of the study group was 88.99%, significantly higher than 66.43% of the control group （P 〈0.05）. Totally 46 strains of pathogens were isolated from the submitted specimens of the 33 patients with infec- tion, of which 50.00% （23 strains ） were gram-negative bacteria, 40. 43% （19 strains ） were gram-positive bac- teria, and 8.70% （4 strains） were fungi. The average hospitalization duration of the control group was （20.39±4.45）days, significantly longer than （14.34±4.59） days of the study group （P〈0.05）. CONCLUSION The mul- timedia technology can significantly reduce the incidence of nosocomial infection in the patients undergoing the car- diac surgery, raise the awareness rate of related knowledge of nosocomial infection of the patients, and shorten the length of hospital stay. It is superior to the conventional health education.