摘要
目的探讨行急诊开颅术后入住ICU监护治疗的患者发生医院感染临床特征,分析相关危险因素,为预防与控制医院感染提供参考。方法收集2011年1月-2012年12月285例急诊入院行开颅手术治疗的危重患者,对其术后在ICU监护治疗患者的临床资料进行回顾性分析,观察其术后医院感染的发生率、感染部位、病原菌种类,并对医院感染因素进行相关性分析。结果 48例患者发生医院感染,感染率为16.84%;感染部位以呼吸道为主,占54.17%,其次为颅内感染,占14.58%;共检出病原菌59株,排前5位依次为鲍氏不动杆菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌和大肠埃希菌,分别占22.03%、16.95%、15.26%、15.26%和13.56%;单因素分析发现年龄、手术时间、术前GCS评分、呼吸机使用、动静脉置管、ICU住院时间是影响患者医院感染的相关危险因素(P<0.05);logistic多因素回归分析显示,手术时间、术前GCS评分和ICU住院时间是急诊开颅术后医院感染的独立危险因素(P<0.05)。结论急诊开颅术后ICU监护治疗医院感染的发生率较高,与多个危险因素相关,应加强医院监督管理及相关制度落实,有效控制感染率。
OBJECTIVE To explore the clinical characteristics of postoperative nosocomial infections in the patients undergoing emergency craniotomy in the ICU and analyze the related risk factors so as to provide guidance for pre‐vention and control of the nosocomial infections .METHODS A total of 285 critically ill patients who were admitted in emergency and underwent the craniotomy from Jan 2011 to Dec 2012 were enrolled in the study ,then the clinical data of the patients who received care and treatment in the ICU after the surgery were retrospectively analyzed ,the incidence of postoperative nosocomial infections ,infection sites ,and species of pathogens were observed ,and the related factors for the nosocomial infections were analyzed .RESULTS The nosocomial infections occurred in 48 pa‐tients with the infection rate of 16 .84% ,of whom 54 .17% had respiratory tract infections and 14 .58% had in‐tracranial infections .Totally 59 strains of pathogens have been isolated ,among which the top five species were the Acinetobacter baumannii （22 .03% ） , Klebsiella pneumoniae （16 .95% ） , Staphylococcus aureus （15 .26% ） , Pseudomonas aeruginosa （15 .26% ） ,and Escherichia coli （13 .56% ） .The univariate analysis indicated that the age ,operation duration ,preoperative GCS ,use of ventilator ,arterio‐venous catheter indwelling ,and length of ICU stay were the related risk factors for the nosocomial infections （P〈0 .05） .The multivariate logistic regression analysis showed that the operation duration ,preoperative GCS ,and length of ICU stay were the independent risk factors for the postoperative nosocomial infections in the patients undergoing emergency craniotomy （P〈0 .05） . CONCLUSION The incidence of postoperative nosocomial infections is high in the emergency craniotomy patients who receive care and treatment in the ICU ,which is associated with multiple risk factors .It is necessary for the hospital to strengthen the supervision and management and implement the related systems so a
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第9期2069-2071,共3页
Chinese Journal of Nosocomiology
基金
国家自然科学基金资助项目(81070061)
关键词
急诊开颅手术
重症监护病房
医院感染
相关因素
Emergency craniotomy
Intensive care unit
Nosocomial infection
Related factor
