急性心肌梗死患者医院感染影响因素分析及其预防措施

An analysis and preventive strategies on nosocomial infection in hospitalized patients with acute myocardial infarction

目的:调查急性心肌梗死患者发生医院感染的情况,分析其影响因素并总结预防措施,以减少医院感染的发生率。方法:回顾性调查中山大学附属第五医院2013年2月—2016年9月收治的412例急性心肌梗死患者资料,调查其发生医院感染情况,采用Logistic回归分析其相关因素,并总结预防对策。结果:急性心肌梗死患者医院感染发生率为16.3%(67/412),感染部位以呼吸道最多见,占50.7%(37/67),感染菌株以革兰阴性杆菌为主,占66.6%(50/75);年龄≥60岁、就诊时间≥6 h、住院时间≥2周、Killip分级≥Ⅲ级、合并糖尿病、合并慢性阻塞性肺病、合并肝肾功能不全和预防性使用抗菌药物是急性心肌梗死患者发生医院感染的危险因素。结论:急性心肌梗死患者医院感染率较高,应针对相关因素采取相应预防措施以减少和控制感染率,有助于改善急性心肌梗死患者的生存质量。

Objective:To investigate the nosocomial infection in hospitalized patients with acute myocardial infarction and provide preventive strategies to reduce the incidence of such infection.Methods:A retrospective review of the clinical data of412patients with acute myocardial infarction during Feb2013to Sep2016was analyzed with Logistic method.Results:The incidence of nosocomial infection in these patients was16.3%(67/412),with the respiratory tract infection(50.7%,37/67)the most common occurrence.Nosocomial infection was observed in relation with many factors,including the patient's age,time of treatment,dysfunction of the left ventricular heart,complication of COPD,and other inflictions such as diabetes,liver and kidney dysfunction.In addition,the duration of hospitalization andProphylactic use of antimicrobial agents also played a role in the infection.Conclusions:The incidence of the nosocomial infection is a common occurrence in the hospitalized patients with acute myocardial infarction,it is necessary to take corresponding preventive countermeasures against the related risk factors in order to reduce and control the infection,and to improve the survival quality of patients with acute myocardial infarction.