重症监护中心(ICU)医护人员SARS感染调查分析

Study on Severe Acute Respiratory Syndrome Nosocomial Infection of Doctors and Nurses in Intensive Care Units

目的了解ICU感染发生原因及影响因素,有效控制ICU医护人员SARS感染。方法采用实地考察,问卷调查,现场访谈、拍照的方式进行。结果7家医院ICU医护人员共感染41例,占感染病例的15.65%(41/262),罹患率为13.53%(0～36.17%)。ICU开中央空调和开窗通风,收治SARS病人与医护人员感染发病有显著差异(X2=11.05,P<0.005);开窗+空气除菌过滤、层流洁净、开空调+空气除菌过滤三者差异非常显著(χ2=28.17,P<0.005)。收治SARS中医医院与综合医院(含专科医院)医护人员发生感染不同,且存在显著差异(χ2=11.55,P<0.005)。结论ICU收治SARS病人是最容易导致医护人员发生感染的高危场所;保持ICU的环境通风、做好个人防护是减少医护人员感染的关键措施。

Objective To find out the reasons and factors associated with nosocomial infection in intensive care units (ICU), in order to prevent and control severe acute respiratory syndrome (SARS). Methods Data on the nosocomial infection were collected by on the spot study, interviewing doctors and nurses, questionare and photograph taking. Results 41 doctors and nurses were infected with SARS through the contact of SARS patients in ICU. The infection rate of SARS in ICU was15.65%(account for 262 total infection cases) and the incidence of doctors and nurses infected by SARS was 13.53%(account for 303 total persons in ICU) in 7 hospitals. The infection rate of doctor and nurse infected by SARS showed great variation between central air conditioning and with door and window opened in ICU (χ2=11.05,P< 0.005). It also showed a marked different in the infection rate among three different conditions: windows opened+air cleaner, lamina ventilation and air conditioning +air cleaner(χ2=28.17,P< 0.005). The infection rate of the traditional comprehensive Chinese medicine hospital in taking SARS patients and the specialized hospital also showed significant difference (χ2=11.55,P< 0.005 ). Conclusions Intensive Care Units (ICU) is the dangerous site for SARS infection of the doctors and nurses who were treating SARS patients. In order to lower the infection rate, the key of control measure are improving environmental ventilation in ICU and keeping a good physical protection of doctor and nurses.