摘要
目的研究有机磷中毒合并呼吸衰竭医院感染发生率及危险因素,探讨相应的防范措施,使有机磷中毒合并呼吸衰竭医院感染能够得到有效预防。方法回顾性分析2008年12月-2012年8月收治的114例有机磷中毒发生医院感染患者的相关临床资料,分析出现医院感染的危险因素,并提出相应的护理防范措施。结果呼吸道感染占首位,感染率为68.42%;合并误吸、血糖水平、超敏C-反应蛋白、胆碱酯酶的活性、手卫生、使用呼吸机、住ICU的时间与医院感染率均有一定的相关性;影响患者发生医院感染的主要危险因素依次为使用呼吸机(OR=19.513、P=0.000)、胆碱酯酶活性(OR=2.116、P=0.013)、合并误吸(OR=2.401、P=0.019)、手卫生问题(OR=2.408、P=0.021)。结论有机磷中毒合并呼吸衰竭医院感染严重威胁患者的生活质量,针对相应的危险因素,合理应用抗菌药物、加强口腔护理、保证严格的无菌操作、熟练操作技能、密切关注患者病情、严格管理制度是十分必要的。
OBJECTIVE To study the incidence and the risk factors of nosocomial infections in organophosphate poisoning patients complicated with respiratory failure and explore the appropriate precautions so as to effectively / prevent the nosocomial infections. METHODS The clinical data of totally 114 organophosphate poisoning patients complicated with nosocomail infections who were treated in the hospital from Dec 2008 to Aug 2012 were retrospectively analyzed, the risk factors of the nosocomial infections were analyzed, and corresponding nursing countermeasures were put forward. RESULTS The incidence of respiratory tract infections was the highest （68. 42%）. The incidence of the nosocomial infections was related to the combined aspiration, blood glucose level, high-sensitivity C-reactive protein, use of ventilator, activity of cholinesterase, hand hygiene, or length of ICU stay; the main risk factors associated with the incidence of nosocomial infections were in turn as follows： the use of ventilator（OR= 19. 513, P=0. 000）, activity of cholinesterase activity （OR=2. 116, P=0. 013）, combined aspiration （OR=2. 401, P=0. 019）, and hand hygiene （OR=2. 408, P=0. 021）. CONCLUSION The incidence of nosocomial infections threatens the life quality of the organophosphate poisoning patients complicated with respiratory failure. Rationally using antibiotics, strengthening oral care, ensuring strict aseptic operation with proficient skills, and paying close attention to the patientrs condition and the management system are essential.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第12期2821-2822,2848,共3页
Chinese Journal of Nosocomiology
关键词
有机磷中毒
呼吸衰竭
医院感染
Organophosphate poisoning
Respiratory failure
Nosocomial infection
