医院获得性肺炎的流行病学特点及预防措施研究

Epidemiological characteristics of hospital-acquired pneumonia and prevention measures

目的探讨分析医院获得性肺炎的流行病学特点及预防措施。方法将2015年1月-12月医院治疗后发生医院获得性肺炎的589例患者作为研究对象,通过查阅电子病历,对研究对象的基本情况、医院感染时间、科室分布及病原菌检测情况进行调查统计,归纳医院获得性肺炎的流行病学特点与影响因素,并制定相关预防措施。结果所调查医院获得性肺炎患者住院时间中位数为26.3天;入院至医院获得性肺炎感染时间中位数为8.6天,医院获得性肺炎病例季节分布差异无统计学意义;神经内外科、重症医学科、肿瘤内科及放疗科医院获得性肺炎病例感染率较其他科室高,科室间分布有统计学差异(P<0.05);医院获得性肺炎病例菌株类型中铜绿假单胞菌、鲍氏不动杆菌的比例最高;气管插管时间长、患者高龄是医院获得性肺炎的影响因素,差异有统计学意义(P<0.05)。结论严格掌握气管插管指征及方法、加强多药耐药菌监测与防控是预防医院获得性肺炎的发生最为有效的方法。

OBJECTIVE To explore the epidemiological characteristics of hospital-acquired pneumonia（HAP）and put forward the prevention measures.METHODS A total of 589 patients with HAP who were treated in the hospital from Jan 2015 to Dec 2015 were recruited as the study objects,the electronic medical records were reviewed,the baselined data,distribution of time and departments of nosocomial infection were statistically analyzed,the epidemiological characteristics and influencing factors for the HAP were summarized,and the related prevention measures were put forward.RESULTS The median length of hospital stay of the enrolled patients with HAP ranged was 26.3 days.There was no significant difference in the seasonal distribution of HAP in the hospital.The incidence of HAP was higher in neurology department,critical medicine department,oncology department and radiotherapy department than in other departments,and there was significant difference（P〈0.05）.Pseudomonas aeruginosa and Acinetobacter baumannii were the predominant species of pathogens isolated from the patients with HAP.The long time of endotracheal intubation and advanced age were the influencing factors for HAP,and there were significant differences（P〈0.05）.CONCLUSIONIt is the most effective way to understand the indications for endotracheal intubation,strengthen the surveillance of multidrug-resistant organisms and take prevention measures so as to prevent HAP.