ICU院内感染高危因素与防治策略探讨

Exploration of High-Risk Factors and Prevention and Treatment Strategies for Nosocomial Infection in ICU

目的总结分析ICU院内感染高危因素与防治策略。方法选择2021年2月—2023年2月本院ICU发生院内感染病例118例为研究对象,分析患者的基本资料、治疗方案等,总结ICU内感染高危因素。结果(1)118例患者的感染部位主要涉及下呼吸道、泌尿道、皮肤软组织、胃肠道、静脉置管等,部分患者合并两处或两处以上感染的情况,下呼吸道感染比例达到了44.07%,比其他部位感染比例明显增高,差异明显有统计学意义(P<0.05)。(2)经数据分析,院内感染的ICU住院患者中以下几类人群的比例更高:抗生素使用种类>2、侵入性操作次数>5、ICU内住院时间>14d、年龄>60岁、使用呼吸机辅助、有插管辅助,差异有统计学意义(P<0.05)。结论ICU院内感染是多种因素共同作用所致,包括患者内在因素(年龄、病情、自身体质、配合度等)、外在因素(医源性因素、治疗方法、住院时间等),抗生素的使用、侵入性操作、住院时间长、辅助呼吸机及导管等都是导致感染的危险因素。ICU院内感染防控要走的路还很长,要做的工作很多,从每个环节去把控,以期提高ICU救治效率。

Objective To summarize and analyze high-risk factors and prevention and treatment strategies for nosocomial infection in ICU.Methods The paper chose 118 cases of nosocomial infection in ICU of our hospital from February 2021 to February 2023 as research subjects,analyzed basic information and treatment records of patients,and summarized infection high-risk factors in ICU.Results①Infection sites of 118 patients mainly involved in lower respiratory tract,urinary tract,skin soft tissue,gastrointestinal tract,venous catheterization,etc.Some patients had two or more concurrent infections,proportion of lower respiratory tract infections reached 44.07%,significantly higher than other infection sites(P<0.05),difference was significant.②After data analysis,proportion of ICU inpatients with nosocomial infections was higher in the following categories:type of antibiotic use>2,number of invasive procedures>5,length of stay in ICU>14 days,age>60,use of ventilator assistance,intubation assistance,chi square test(P<0.05).Conclusion Nosocomial infection in ICU is caused by multiple factors,including internal factors(age,condition,physical fitness,compatibility,etc.)and external factors(iatrogenic factors,treatment methods,hospital stay,etc.).Risk factors for infection include antibiotics use,invasive procedures,long hospital stay,auxiliary ventilators and catheters.There is a long way to go in prevention and control of infection in ICU,and a lot of work to do to control it from each aspect and improve efficiency of ICU treatment.