门诊胃镜室诊疗患者医院感染的临床特点、危险因素及规范化操作管理预防分析

Clinical characteristics and risk factors of nosocomial infection in patients diagnosed and treated in outpatient gastroscope room and analysis of standard operation management and prevention

目的探讨门诊胃镜室诊疗患者医院感染的临床特点、危险因素及规范化操作管理预防分析。方法对2015年6月至2017年6月门诊胃镜室诊疗的500例患者的临床资料进行回顾性分析,记录医院感染率及其临床特点,收集纳入病例患者临床资料,对其医院感染进行单、多因素分析,同时分析规范化操作管理预防措施。结果 500例病例患者,有32例发生医院感染,医院感染率为6.40%(32/500),医院感染部位以消化道、上呼吸道、泌尿生殖系统、皮肤软组织感染最为常见;感染组年龄≥65岁、有侵入性操作、联合使用抗菌药物、无菌操作不合格、器械灭菌不合格、空气消毒不合格所占比例较未感染组明显高(P<0.05);年龄≥65岁、侵入性操作、无菌操作不合格、器械灭菌不合格、空气消毒不合格是门诊胃镜室诊疗患者医院感染的独立危险因素。结论门诊胃镜室诊疗患者医院感染主要分布部位为消化道、上呼吸道,年龄≥65岁、侵入性操作、无菌操作不合格、器械灭菌不合格、空气消毒不合格是增加其医院感染的影响因素,临床应据此实施规范化操作管理预防措施。

Objective To explore the clinical characteristics and risk factors of nosocomial infection in patients diagnosed and treated in outpatient gastroscope room and analysis of standard operation management and prevention.Me thods The clinical data of 500 patients who were diagnosed and treated in the outpatient gastroscope room of a hospital from June 2015 to June 2017 were analyzed retrospectively.The rate and clinical characteristics of nosocomial infection were recorded.The clinical data of the included cases were collected for univariate and multivariate analysis and standard operation management and preventive measures were analyzed.Re s ults There were 32 cases with nosocomial infection in the 500 cases and the nosocomial infection rate was 6.40%（32/500）.The most common sites of nosocomial infection were digestive tract,upper respiratory tract,genitourinary system and skin soft tissues.The proportions of patients being or above 65 years old,invasive operation,combined use of antibiotics,unqualified aseptic operation,unqualified sterilization of equipment and unqualified air sterilization in the infected group were significantly higher than those in the uninfected group（ P〈0.05）.Age being or above 65 years old,invasive operation,unqualified aseptic operation,unqualified sterilization of equipment and unqualified air sterilization were independent risk factors of nosocomial infection in patients diagnosed and treated in outpatient gastroscope room.Conclus ion The main sites of nosocomial infection in patients diagnosed and treated in outpatient gastroscope room are digestive tract and upper respiratory tract.Age being or above 65 years old,invasive operation,unqualified aseptic operation,unqualified sterilization of equipment and unqualified air sterilization are influencing factors of nosocomial infection.Therefore,standard operation management prevention measures should be taken accordingly.