血液系统疾病患者医院感染的临床护理研究

Clinical nursing of hematological diseases patients with nosocomial infections

目的探讨不同护理模式对血液系统疾病患者住院期间发生医院感染的影响。方法选择2011年1月-2016年12月在医院住院治疗的1024例患者为研究对象,其中2011年1月-2013年12月治疗的425例患者作为对照组,2014年1月-2016年12月治疗的599例患者作为试验组;对照组患者采取常规护理方法,试验组采用针对血液科患者的综合护理方法,比较两组患者的医院感染发生情况。结果对照组84例患者发生医院感染,感染率为19.76%,试验组52例患者发生医院感染,感染率为8.68%,两组比较差异有统计学意义(P<0.05);急性白血病患者医院感染率最高为21.26%,其次为骨髓增生异常综合征患者为17.35%;对136例感染患者的感染部位进行分析,感染部位以呼吸道感染为主,占58.82%,其次依次为血液系统、消化道系统、泌尿系统和皮肤;感染患者临床标本中共检出病原菌136株,其中革兰阴性菌91株占66.91%,革兰阳性菌30株占22.06%。结论对血液系统疾病的住院患者,采用针对血液科患者的综合护理方法,可使医院感染率下降;患者中以急性白血病患者的医院感染率最高,感染部位以呼吸系统所占比例最高,检出病原菌以革兰阴性菌为主。

OBJECTIVE To explore the influence of nursing modes on incidence of nosocomial infections in patients with hematological diseases during hospital stay. METHODS A total of 1024 patients who were hospitalized for treatment from Jan 2011 to Dec 2016 were recruited as the study objects, 425 patients who were treated from Jan 2011 to Dec 2013 were assigned as the control group, and 599 patients who were treated from Jan 2014 to Dec 2016 were set as the observation group.The control group was treated with conventional nursing modes, while the observation group was given comprehensive nursing measures in response to the patients of hematology depart- ment.The incidence of nosocomial infections was compared between the two groups of patients.RESULTS Totally 84 patients had nosocomial infections in the control group, with the infection rate 19.76% ; totally 52 patients had nosocomial infections in the observation group, with the infection rate 8.68%% there was significant difference be- tween the two groups （P〈0.05）.The incidence rate of nosocomial infections was 21.26% in the patients with a- cute leukemia, 17.35% in the patients with myelodysplastic syndrome. Among the 136 patients with the infec- tions, the patients with respiratory tract infections （58.82 %） were dominant, followed by the patients with blood system infections, the patients with gastrointestinal tract infections, the patients with urinary tract infections and the patients with skin infections.A total of 136 strains of pathogens were isolated from the clinical specimens that were obtained from the patients with the infections, of which 91 （66.91%） were gram-negative bacteria, and 30 （22.06%） were gram-positive bacteria.CONCLUSION It is necessary to take the comprehensive nursing measures for the patients with hematological diseases who are hospitalized the hematology department so as to reduce the in- cidence of nosoeomial infections.The incidence rate of nosoeomial infections is the highest among the patients with acute leukemia, the respiratory system is the predominant infection site, and the gram-negative bacteria are domi-nant among the isolated pathogens.