血液系统疾病患者并发院内感染的危险因素及护理干预效果观察

Risk factors of nosocomial infection in patients with hematological system diseases and the effect of nursing intervention

目的 观察血液系统疾病患者并发院内感染的危险因素及护理措施的干预效果。方法 选取本院2017年1月至2018年12月入住本院的血液系统疾病患者104例,依据患者并发感染情况分为感染组(52例)、未感染组(52例)。采集患者一般资料及治疗方式差异,经单因素及多因素分析明确血液系统疾病并发感染的危险因素;并将感染组患者运用随机数字表法分为A组(26例)、B组(26例),A组采用专项护理措施,B组采用常规护理,对比A、B两组患者的护理效果。结果 血液系统疾病并发院内感染的危险因素包括体质量指数偏低、粒细胞缺乏、大剂量激素治疗、化疗前口腔黏膜疾病(OR<1,P<0.05);预防性抗真菌药物治疗属于保护性因素(OR>1,P<0.05);A组口腔黏膜炎、意外脱管、化疗药物外渗、腹泻及肛周皮肤破损、护理相关医源性损伤、复发院内感染患者的发生率均显著低于B组(P<0.05)。结论 血液系统疾病院内感染的危险因素为体质量指数偏低、粒细胞缺乏、大剂量激素、化疗前口腔黏膜损伤,采用专项护理措施能够有效降低患者口腔黏膜炎、腹泻及肛周皮损、护理相关医源性损伤及复发院内感染风险,在患者治疗过程中应注重预防性应用抗真菌药物,有助于改善患者预后。

Objective To observe the risk factors of nosocomial infection in patients with hematological system diseases and the intervention effect of nursing measures. Methods From January 2017 to December 2018, 104 patients with hematological system diseases were divided into infection group (52 cases) and control group (52 cases). The general data and treatment methods of the patients were collected, and the risk factors of hematological system diseases associated with infection were identified by univariate and multivariate analysis. The patients in the infection group were randomly divided into group A (26 cases) and group B (26 cases). Group A was given specific nursing measures, and group B was given routine nursing care. The nursing effects of group A and group B were compared. Results The risk factors of nosocomial infection in patients with hematological system diseases included low body mass index (BMI), granulocytopenia, and high-dose hormone therapy (OR<1, P<0.05);preventive antifungal therapy was a protective factor (OR>1, P<0.05). The incidences of oral mucositis, unexpected extubation, chemotherapeutic extravasation, diarrhea, perianal skin damage, nursing-related iatrogenic injury, and recurrent nosocomial infection in group A were significantly lower than those in group B (P<0.05). Conclusions The risk factors of nosocomial infection in patients with hematological system diseases were low body mass index (BMI), granulocytopenia, high dose of hormone, and oral mucosal injury before chemotherapy. Special nursing measures could effectively reduce the risk of oral mucositis, diarrhea, perianal skin lesions, nursing-related iatrogenic injury, and recurrent nosocomial infection. We should pay attention to the prophylactic use of antifungal drugs in the course of treatment, which is helpful to improve the prognosis of the patients.