摘要
目的了解某医院心血管外科连续5年医院感染的现状，分析感染相关因素，以便采取有效措施降低医院感染发生率。方法方便抽样某医院2010年1月~2014年12月出院患者中的19025例，其中确诊医院感染553例。采用回顾性分析方法，收集553例感染患者的一般资料和相关数据，具体包括性别、年龄、住院期间情况、手术情况、入住ICU的时间等。结果5年间共有553例感染患者，其中男性343例（62%），女性210例（38%），年龄1~52岁，其中60岁以上77例（13.9%）。住院期间发生抢救119例（21.5%）、手术467例（84.4%）、输血447例（80.8%）、透析57例（10.3%）。入住ICU的时间为4.0（2.0~9.0）d，其中≥5d的患者276例（49.9%）。住院期间平均最高体温（38.85±0.68）℃，其中最高体温≥39.0℃患者248例（44.8%）。术前应用第三代头孢菌素309例（55.9%），术后应用抗生素种类为2.0（1.0~3.0）种。术后静脉导管留置时间为7.0（5.0~8.5）d，其中≥7d患者284例（51.4%）；白蛋白＜40g/L患者314例（56.8%）；红细胞比容＜0.40患者272例（49.2%）。最常见的医院感染类型依次是肺部感染（43.6%）、上呼吸道感染（30.0%）和血流感染（25.7%）。二元Logistic回归分析，结果发现女性、术前应用第三代头孢菌素为血流感染的保护因素，年龄≥60岁、入住ICU时间≥5d、住院期间最高体温≥39.0℃、白蛋白＜40g/L、红细胞比容＜0.40、术后静脉导管留置时间≥7d为危险因素。先天性心脏病、住院期间输血为肺部感染的保护因素，入住ICU时间≥5d、住院期间透析、住院期间手术、术后静脉导管留置时间≥7d、术后使用抗生素数目≥3种为危险因素。结论心血管外科住院患者发生医院感染的相关因素众多，医务工作者可以采取加强患者住院期间生理功能的改善、减少入住ICU时间、减少静脉导管留置时间和合理使用抗生
Objective To survey the status of nosocomial infection in the department of cardiovascular surgery of a grade III-A hospital in five consecutive years and analyze relevant factors for taking effective measures to reduce the incidence of nosocomial infection. Methods The discharged patients (n=19 025) were chosen from the department of cardiovascular surgery of a grade III-A hospital from Jan. 2010 to Dec. 2014, and among them 553 were diagnosed as nosocomial infection cases. The general materials and relevant data were collected from 553 patients including sex, age, hospitalization status, surgery status and duration of staying in intensive care unit (ICU) by applying retrospective analysis method. Results In five consecutive years, there were totally 553 patients with nosocomial infection, among them 343 (62%) were the male, 210 (38%) were the female, their age was from 1.0 to 52, and there were 77 (13.9%) patients aged over 60. There were 119 (21.5%) patients undergone rescue,467 (84.4%) accepted surgery, 447 (80.8%) with blood transfusion, and 57 (10.3%) with dialysis. The duration of staying in ICU was 4.0 (2.0-9.0) d, and there were 276 (49.9%) patients with duration of staying in ICU≥5 d. The average highest body temperature was (38.85±0.68) ℃ in patients during staying in hospital, and among them there were 248 (44.8%) cases with the highest body temperature≥39.0℃. There were 309 (55.9%) patients treated with the third generation cephalosporin before the surgery, and there were 2.0 (1.0-3.0) kinds of antibiotics used after the surgery. The indwelling duration of venous catheter was 7.0 (5.0-8.5) d and there were 284 (51.4%) patients with indwelling duration≥7 d. There 314 (56.8%) patients with albumin<40 g/L and 272 (49.2%) patient with hematocrit (Hct)<0.40. The most common nosocomial infection types were pulmonary infection (43.6%),upper respiratory tract infection (30.0%) and bloodstream infection (25.7%). The results of binary Logistic regression analysis showed that female and the third gen
作者
戴丽文
丁敬美
付菊芳
刘冰
孙惠英
史皆然
DAI Li-wen;DING Jing-mei;FU Ju-fang;LIU Bing;SUN Hui-ying;SHI Jie-ran(Department of Disease Prevention and Control, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China)
出处
《中国循证心血管医学杂志》
2016年第8期952-954,共3页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
医院感染
感染部位
危险因素
心血管外科
Nosocomial infection
Infection site
Risk factors, Department of cardiovascular surgery
