ICU患者院内感染与家属探视方式的关系研究

Study on Relationship between Nosocomial Infection and Family Visits for ICU Patients

目的探讨重症监护病房患者家属不同的探视方式对患者发生院内感染的影响,以期为科学合理地安排探视提供参考。方法将2017年2月至2018年2月的ICU患者225名作为对照组,采用弹性探视方式,将2018年3月至2019年2月的225名患者作为实验组,采用限制性探视方式,比较两组患者院内感染率,空气中的病原菌分布情况,探讨影响患者发生院内感染的相关因素。结果对照组患者发生院内感染76例,院内感染率为33.78%,试验组患者感染51例,院内感染率为22.67%,试验组院内感染率低于对照组(p<0.05)。不同季节试验组的空气细菌数量均低于对照组(p<0.05)。Logistic回归分析显示,每天探视时间≥20分钟,探视次数≥2次,增加患者院内感染率;每天仪器及空气消毒次数≥2次能够降低院内感染率,差异具有统计学意义(p<0.05)。结论探视时间增加、探视次数增多,患者发生院内感染的几率增加;仪器及空气消毒次数增加,能够降低患者院内感染率。两种探视方式相比,限制性探视方式是一种较好的探视方式。

Objective To explore the influence of different family visiting system for patients in Intensive Care Unit(ICU)on nosocomial infections,and to provide reference for arranging visiting scientifically.Methods A total of 225 ICU patients from February 2017 to February 2018 were included as the control group,and flexible visit system was adopted.And 225 patients from March 2018 to February 2019 were included as the experimental group,and restricted visit system was adopted.The nosocomial infection rate and the distribution of pathogenic bacteria in the air in the two groups of patients were compared to explore the factors affecting the nosocomial infection.Results There were 76 patients getting nosocomial infection in the control group,accounting for 33.78%,and there were 51 in the experimental group,accounting for 22.67%.The infection rate of experimental group was significantly lower than this of control group(p<0.05).The number of bacteria in the air of the experimental group of different seasons were all smaller than those of the control group.Regression analysis showed that the nosocomial infection rate increased when the length of visit was longer than 20 minutes and the number of visits was more than 2.Sterilizing the facilities and the air more than twice every day could decrease the nosocomial infection rate of ICU,and the difference was statistically significant(p<0.05).Conclusion Compared with the two methods of visit,the restrictive way of visiting is a better way to visit,which can reduce the risk of nosocomial infection.Increased length of visit and frequency of visits increases the nosocomial infection rate,while increased frequency of sterilizing the facilities and the air decreases the nosocomial infection rate.Therefore,restricted visiting system is better than flexible visit system.