顾海文,蔡成伟
GU Haiwen,CAI Chengwei

• 1:上海市浦东北蔡社区卫生服务中心

摘要(Abstract)：

目的:了解脑血管疾病患者院内感染现状及造成感染的危险因素,为医院加强防治工作提供依据。方法:收集脑血管患者346例的临床资料,根据患者的年龄、意识障碍、侵入性操作(包括尿管、鼻饲管)、住院天数等情况,对感染患者的病原体进行检测,了解脑血管疾病患者院内感染情况,分析感染高危因素及感染发生率。结果:346例患者中有64例患者发生院内感染(17.63%),病原菌主要以革兰氏阴性菌为主,占感染患者的59.02%;感染的部位主要集中在呼吸系统、泌尿系统,少部分患者出现皮肤黏膜的感染,还有部分患者出现消化道感染以及发生双重感染等;<60岁的患者院内感染率比>60岁的患者院内感染率小,两者差异具有统计学意义(χ2=6.21,P=0.013);对不同意识状态患者院内感染了进行比较,嗜睡/昏睡患者和昏迷患者的医院感染发病率明显比意识清醒患者的医院感染发病率高,差异具有统计学意义(χ2=5.4、5.18,P=0.02、0.023);未实施导尿患者的医院感染率显著低于实行导尿患者感染率,差异具有统计学意义(P<0.001);出现感染患者住院时间比未出现医院感染的患者住院天数多,两者比较差异具有统计学意义(t=14.16,P<0.001)。结论:脑血管疾病患者院内感染主要高危因素为年龄、意识障碍程度、住院天数以及是否实施侵袭性操作,应采取相应措施减少患者院内感染率,改善预后。
Objective: To study the general status and risk factors of nosocomial infection in patients with cerebrovascular disease. Methods: A total of 346 patients with cerebrovascular disease were enrolled in this study. The general status,risk factors and incidence of nosocomial infection in these patients were analyzed. Results: Sixty-one patients( 17. 63%) infected in hospital. The predominant pathogen of nosocomial infection was Gram negative bacilli(59. 02%). The main infection sites were respiratory system,urinary system,and some patients with skin mucosa infection,gastrointestinal infection or double infection; nosocomial infection rate of patients below 60 years old was lower than that of patients above 60 years old,the difference was statistically significant( χ2= 6. 21,P = 0. 013); nosocomial infection rate of somnolence or lethargy and coma patients was higher than that in conscious patients,( χ2= 5. 4,5. 18,P = 0. 02,0. 023); nosocomial infection rate in patients wthout implementation of urethral catheterization was significantly lower than that in patients with implementation of urethral catheterization( P < 0. 001); hospitalization time of patients with nosocomial infection was much longer than that of patients without nosocomial infection( t = 14. 16,P < 0. 001). Conclusion: The risk factors of nosocomial infection are age( > 60),consciousness disorders,long hospitalization time and receiving the invasive operation or not.

关键词(KeyWords)： 脑血管疾病;感染,医院内;危险因素;细菌
cerebrovascular diseases;infection,nosocomial;risk factor;bacteria

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 顾海文,蔡成伟
GU Haiwen,CAI Chengwei

DOI: 10.19367/j.cnki.1000-2707.2015.08.025

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