精神分裂症患者医院感染的影响因素分析

Influencing factors for nosocomial infection in patients with schizophrenia

目的探讨精神分裂症患者发生医院感染的影响因素。方法采用回顾性分析方法,随机选择医院2014年10月-2016年10月收治的精神分裂症患者566例为研究对象。对受试者的临床资料(性别、年龄、病程、住院时间、疾病特征、治疗措施、感染部位等)进行统计。统计入组患者医院感染的种类及构成比,对受试者的临床资料与医院感染进行单因素及多因素Logistic回归分析。结果 566例精神分裂症患者中,11例患者发生医院感染,感染发生率为1.94%,感染类型以呼吸道感染为主;多因素Logistic回归分析结果显示,SAPS阳性及SANS阴性症状评分、药物副反应评分、保护性约束时间、改良电休克治疗、使用抗精神病药物>2种为精神分裂症患者发生医院感染的独立影响因素(P<0.05)。结论临床症状严重、实施保护性约束或电休克治疗、使用抗精神病药物>2种及药物副反应严重的精神分裂症患者是医院感染的高危人群,应建立筛选机制,实施综合目标监测,以降低医院感染的发生风险。

OBJECTIVE To explore the influencing factors for nosocomial infection in the patients with schizophrenia.METHODS By means of retrospective survey,totally 566 patients with schizophrenia who were treated in the hospital from Oct 2014 to Oct 2016 were recruited as the study objects.The clinical data of the participants,including gender,age,disease course,length of hospital stay,characteristics of diseases,treatment measures and infection sties,were statistically analyzed.The constituent ratios of the types of nosocomial infection were statistically analyzed,and univariate analysis and multivariate logistic regression analysis were performed for the clinical data of the participants and the nosocomial infection.RESULTS Of the 566 patients with schizophrenia,11 had nosocomial infection,with the incidence rate of infection 1.94%;the patients with respiratory tract infection were dominant among the patients with nosocomial infection.The result of the multivariate logistic regression analysis indicated that the SAPS-positive and SANS-negative symptoms scores,score of drug-induced side reactions,protective restriction time,modified electroconvulsive therapy and use of more than 2 types of antipsychotic drugs were the independent influencing factors for the nosocomial infection in the patients with schizophrenia（P〈0.05）.CONCLUSIONS The severe clinical symptoms,protective restriction or electroconvulsive therapy,use of more than 2 types of antipsychotic drugs and severe drug-induced side reactions are the high risk factors for the nosocomial infection in the patients with schizophrenia.It is necessary to establish the screening mechanisms and carry out comprehensive and targeted monitoring so as to reduce the risk of nosocomial infection.