摘要
目的探讨老年冠状动脉粥样硬化性心脏病(冠心病)合并心力衰竭(心衰)患者院内感染的临床特点及相关因素分析。方法收集2018年1月至12月于解放军总医院第一医学中心(以下简称我中心)收治的130例老年冠心病合并心衰患者的临床资料,记录并统计发生院内感染患者的临床特点(感染部位、病原菌种类和构成比等)及相关影响因素(住院时间、使用激素、侵入性操作、抗菌药物、病变血管支数等),探讨院内感染防控对策。结果130例患者中发生感染40例,其中呼吸系统感染15例,泌尿系统感染12例,消化系统感染8例,血液系统感染5例。40例感染患者中,培养病原菌63株,其中革兰阴性菌36株(57.14%);革兰阳性菌22株(34.92%);真菌5株(7.94%)。单因素分析结果显示,住院时间、使用激素、侵入性操作、抗菌药物、病变血管等因素均是患者发生院内感染的相关性因素(P<0.05);多因素Logistic回归分析结果显示,住院时间、侵入性操作、多支病变血管等因素是患者院内感染的相关性因素(P<0.05)。结论老年冠心病合并心衰患者其发生院内感染的部位,主要是呼吸系统,主要病原菌为革兰阴性菌,相关因素为住院时间、侵入性操作、多支病变血管。治疗中,应加强对合理使用抗菌药物,严格无菌操作,减少侵入性操作时长和次数,加强营养支持和护理干预,从而降低院内感染发生几率。
Objective To investigate the clinical characteristics and relevant factors of nosocomial infection in elderly patients with coronary heart disease(CHD)complicated by heart failure(HF).Methods The clinical materials were collected from the elderly patients with CHD complicated by HF(n=130)treated in the First Medical Center of Chinese PLA General Hospital from Jan.2018 to Dec.2018.The clinical characteristics(infection sites,types and composition ratio of pathogens,etc.),and relevant factors(length of hospital stay,use of hormones,invasive procedures,antibiotics,number of diseased blood vessels,etc.)were recorded and treated statistically in the patients with nosocomial infection.The countermeasures of controlling nosocomial infection were discussed.Results Among 130 patients,40 cases suffered from infection,including 15 cases of respiratory system infection,12 cases of urinary system infection,8 cases of digestive system infection and 5 cases of blood system infection.In 40 infected patients,there were 63 strains of pathogenic bacteria cultured,including 36 strains of Gram-negative bacteria(57.14%),22 strains of Gram-positive bacteria(34.92%)and 5 strains of fungi(7.94%).The results of single-factor correlation analysis showed that length of hospital stay,use of hormones,invasive procedures,antibiotics and diseased blood vessels were relevant factors of nosocomial infection(P<0.05).The results of Logistic regression analysis showed that length of hospital stay,invasive procedures and multiple diseased blood vessels were relevant factors of nosocomial infection(P<0.05).Conclusion The site of nosocomial infection is mainly respiratory system,major pathogenic bacteria is Gram-negative bacteria,and relevant factors are length of hospital stay,invasive procedures and multiple diseased blood vessels.In the treatment,it is necessary to strengthen rational application of antibiotics and sterile technique,cut down the duration and frequency of invasive operations,enhance nutritional support and nursing intervention and re
作者
冯特
熊琦
安东立
盛英文
Feng Te;Xiong Qi;An Dongli;Sheng Yingwen(Beijing West Medical District of Chinese PLA General Hospital,Beijing 100043,China;不详)
出处
《中国循证心血管医学杂志》
2022年第7期872-874,共3页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
冠心病
心力衰竭
院内感染
相关因素
Coronary heart disease
Heart failure
Nosocomial infection
Relevant factors
