缺血性脑卒中院内感染的危险因素分析

Analysis of risk factors for hospital infection in cerebral ischemic stroke

目的探讨缺血性脑卒中院内感染的危险因素,为临床提供防控措施。方法研究对象为2016-02—2017-03在郑州中心医院神经内科住院治疗的缺血性脑卒中患者428例,其中83例感染者为感染组,余345例未感染者随机抽取83例为对照组进行回顾性分析。结果院内感染的发生率为19.39%(83/428,),患者感染部位依次为泌尿系统(42/83,50.60%)、呼吸系统(12/83,33.73%)、其他(13/83,15.66%)。单一部位感染76例(91.57%),合并两个及以上部位感染7例(8.43%)。感染的病原菌依次是:大肠埃希菌、肺炎克雷伯杆菌、金黄色葡萄糖球菌。脑卒中合并糖尿病的患者医院感染的独立预测危险因素。预防性应用抗生素不能预防医院感染。侵袭性操作会使感染机会增多。结论脑卒中患者院内感染的感染部位主要在泌尿系,病原菌以革兰阴性菌为主,患有糖尿病的脑卒中可能是医院感染的独立危险因素。加强对原发病的诊治、严控对抗生素的使用。对侵入性操作,应严格无菌技术,及时排痰等,从而改善患者的预后。

Objective To explore the common risk factors of cerebral ischemic stroke co infection,for clinical prevention and control measures.Methods This research object for February 2016 to Marh 2017 in our hospital neurology hospital treatment of patients with stroke,a total of 428 cases,including 83 cases of infection group,more than 345 cases of uninfected random 83 cases for the uninfection group for retrospectively analyzed.Results This study found that the incidence of hospital infection for,19.39%(83/428),patients infected place foll owed by urinary system50.60%(42/83),respiratory,33.73%(12/83),the other 15.66%(12/83).Single site infection76 cases(91.57%),with more than two7 cases(8.43%).The pathogens isolated were in order as follows:Escherichia coli,Klebsiella pneumonia and golden glucose coccus.Diabetes patients with stroke is independent risk factors for nosocomial infection.The prophylactic use of antibiotics and cannot prevent hospital infection.Invasive operation such as endotracheal intubation,indwelling gastric tube indwelling urethral catheterization,sputum suction multiply infection,etc.Conclusion Stroke patients with hospital infection of parts are mainly concentrated in the urinary system,infection of pathogenic bacteria is given priority to with gram negative bacteria,may be independent risk factors for nosocomial infection with diabetes mellitus.To strengthen the treatment of primary disease,strict management of the use of antibiotics.Invasive operation,should be strictly aseptic technique operation,timely sputum suction,etc.,so as to improve the prognosis of patients.