消化内科患者发生院内感染的危险因素及护理对策分析

Risk factors and nursing strategy of hospitalized patients with hospital acquired infection in the department of gastroenterology

目的探究消化内科患者院内感染的危险因素及护理对策。方法选取本院收治的600消化内科住院患者作为研究对象。其中42例发生院内感染,列入感染组;558例未发生院内感染,列入未感染组。统计院内感染发生的常见感染部位。分别采取单因素分析和多元logistic回归分析方法,分析年龄、糖尿病、消化道肿瘤、消化系统手术、侵入性操作、激素治疗、联合使用抗生素、住院时间、超敏C反应蛋白、血清白蛋白、血红蛋白、低钠血症及低钾血症与院内感染的关系。根据危险因素制定相应的护理对策。结果总的院内感染发生率为7%(42/600),包括呼吸道24例(57.14%),泌尿系统7例(16.67%),消化道6例(14.29%),血液2例(4.76%),皮肤黏膜2例(4.76%)及其他部位1例(2.38%)。单因素分析结果显示,低钠血症和低钾血症与消化内科住院患者院内感染的发生无关(P>0.05)。多元logistic回归分析结果显示,侵入性操作(OR=3.400)、血清白蛋白水平<40g/L(OR=2.536)、联合应用抗生素(OR=2.494)、合并糖尿病(OR=2.427)、消化道肿瘤(OR=2.300)、年龄≥60岁(OR=2.176)及hs-CRP≥10 mg/L(OR=2.014)是影响消化内科住院患者院内感染的危险因素(P<0.05)。结论消化内科住院患者具有较低的院内感染发生风险,依据院内感染发生危险因素制定护理对策降低HAIs的发生风险。

Objective To explore the risk factors and the nursing strategy of hospitalized patients with hospital acquired infection （HAIs） in the department of gastroenterology. Methods Totally 600 hospitalized patients in the department of gastro- enterology were selected as research objects： 42 cases were With HAIs and belonged to the infection group, and 558 cases were not with HAIs and belonged to the non-infection group. The common parts of infection was counted. Single factor analysis and lo- gistic analysis were used to analyze the relations of 13 factors （age, diabetes, digestive tract tumors, digestive system surgical procedures, invasive procedure, hormonotherapy, combination use of antibiotics, length of stay, hypersensitive C-reactive protein （hs-CRP） , serum albumin, hemoglobin, hyponatremia and hypokalemia） with HAIs, in order to identify risk factors. The nurs- ing strategy was made according the risk factors. Results The tot/d infection rate was 7% , including 24 cases in respiratory tract （57.14%） , 7 cases in urinary system （ 16.67% ） , 6 cases in digestive tract （ 14.29% ） , 2 cases in blood （4.76%） , 2 cases in skin and mncosa （4.76%） , and 1 case in others （2.38%）. Single factor analysis showed that hyponatremia and hy- pokalemia were irrelevant to HAIs （ P〉0.05 ）. The logistic analysis showed that invasive procedure （ OR ： 3. 400）, the level of serum albumin〈40g/L （ OR = 2. 536 ） , combination use of antibiotics （ OR = 2. 494）, diabetes （ OR = 2. 427 ）, digestive tract tumors （ OR= 2. 300）, age ≥60 （ OR= 2. 176） and hs-CRP≥ 10mg/L （ OR=2. 014） were the risk factors of HAIs （ P〈0.05 ）. Conclusion Inpatients in the department of gastroenterology have a low ratio of HAIs. The nursing strategy made according the risk factors can effectively reduce the ratio of HAIs.