回顾性研究肿瘤患者院内感染的相关因素及防制对策

Retrospective Study on Nosocomial Infection and Related Factors in Cancer Patients

目的 了解肿瘤患者院内感染发病情况 ,分析发生院内感染的原因 ,以便加强监测和防制。方法 查阅 1 999～ 2 0 0 2年住院病例 1 70 1 5份 ,逐份进行回顾性调查分析。结果 4年中总出院人数为 1 70 1 5例 ,发生院内感染 1 0 6 8例 ,感染率为 6 3% ,各感染部位以呼吸道为最高 ,占 5 0 1 % ,各月份感染率以 6～ 9月居高 ,院内感染与住院时间、年龄、死亡率有关 ,抗生素的使用率较高 ,微生物学送检率较低 ,病原菌主要为条件致病菌 ,其中G-杆菌占6 1 8% ,真菌占 1 0 9%。结论 医院布局合理 ,各项规章制度完善 ,医务人员院内感染监控知识和职业道德的强化 ,加强院内感染的监测及院内感染漏报率、病原送检管理 ,合理使用抗生素等 。

Objective To evaluate the nosocomial infection and related factors in hospitalized cancer patients so as to enhance the monitoring and prevention of the incidence rate of nosocomial infection in cancer hospital. Methods From 1999 to 2000, 17015 hospitalized cases were reviewed and included for retrospective analysis in this study. Results The nosocomial infection rate in this cohort was 6 3%(1068/17015) with a highest incidence of 50 1% in the respiratory system. The incidence rate varied from 4 8% to 7 7% each month and the higher incidence appeared from June to September. Statistic analysis indicated that nosocomial infection was highly related to hospitalized period, age and mortality. Gram negative bacilli accounted for 61 8% of the pathogen while fungus accounted for 10 9%. Conclusion Setting up of a consummate controlling system and administrative policy to strengthen the monitoring of nosocomial infection, decrease the omissive reporting rate and increase the pathogen detection should help further prevention of nosocomial infection. Rational application of antibiotics as well as improvement of patients′ immune system by medicine seems warranted.