甲氨蝶呤过量至粒细胞缺乏患者无菌病房医院感染的相关因素及护理对策

Related factors of nosocomial infection in sterile ward of patients with agranulocytosis caused by over methotrexate and nursing strategies

目的探讨甲氨蝶呤过量至粒细胞缺乏患者无菌病房医院感染的危险因素,并给予相应的护理对策。方法选取2018年2月至2020年2月本院进行大剂量甲氨蝶呤治疗后出现粒细胞缺乏患者70例,患者入住无菌病房。将发生医院感染者作为发生组,未发生医院感染者作为未发生组,收集患者一般资料和临床信息,同时采用单因素和多因素logistic回归法对甲氨蝶呤过量至粒细胞缺乏患者无菌病房医院感染的相关因素和主要因素进行分析。结果选取的70例患者中,有11例患者出现医院感染,发生率为15.71%。经多因素logistic回归分析,家属缺乏无菌知识、未定期维护净化系统及手卫生未达标等为导致患者发生医院感染的主要因素。结论家属缺乏无菌知识、未定期维护净化系统及手卫生未达标等为导致甲氨蝶呤过量至粒细胞缺乏患者无菌病房医院感染的主要因素,护理人员应明确上述因素,强化护理干预,避免或减少医院感染的同时,提高患者生存质量。

Objective To explore the risk factors of nosocomial infection in sterile ward of patients with agranulocytosis caused by over methotrexate,and to give corresponding nursing countermeasures.Methods From February,2018 to February,2020,70 patients with agranulocytosis after high-dose methotrexate therapy were admitted to the sterile ward.According to whether they had nosocomial infection,the patients were divided into an occurrence group and a non-occurrence group.Their general and clinical information was collected.Univariate and multivariate logistic regressions were used to analyze the related factors and main factors of nosocomial infection in sterile ward of the patients.Results Of the 70 patients,11 had nosocomial infection,and the incidence was 15.71%.The main factors leading to nosocomial infection were the lack of aseptic knowledge,the failure of regular maintenance of purification system,and unqualified hand hygiene.Conclusion Family members'lack of aseptic knowledge,failure to regularly maintain decontamination system,and unqualified hand hygiene are the main factors that lead to nosocomial infection in sterile wards of patients with agranulocytosis caused by over methotrexate;and nursing staff should make clear the above factors and strengthen nursing intervention to avoid or reduce hospital infection and to improve their quality of life.