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重症监护病房患者医院感染的相关因素分析及对策 被引量:10

Monitoring and analysis of the relevant factors and strategies of nosocomial infection in intensive care unit
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摘要 目的:了解重症监护病房( ICU)住院患者医院感染的特点及影响因素,为制定防控对策提供依据。方法采用目标性监测方法,对2013年1-12月入住ICU的患者进行前瞻性监测,并对监测资料进行统计分析。结果677例患者中,163例发生医院感染,医院感染率为24.1%;感染212例次,感染例次率为31.3%;感染主要部位依次是呼吸道(143例次,67.5%)、血液(28例次,13.2%)和泌尿道(15例次,7.1%);感染的主要病原菌依次是鲍曼不动杆菌(64株,30.2%)、铜绿假单胞菌(35株,16.5%)和肺炎克雷伯菌(24株,11.3%)。不同年龄、住院时间、入ICU时疾病诊断个数、机械通气时间患者及有无气管插管、深静脉置管、留置导尿管患者医院感染发生率比较差异均有统计学意义(P<0.05)。结论应针对ICU医院感染的相关因素采取相应的防控对策,严格执行无菌操作规程和消毒隔离制度、加强手卫生、做好侵入性操作的管理,尽量缩短患者的住院时间、合理使用抗菌药物等是降低ICU患者发生医院感染的关键措施。 Objective To investigate the characteristics of nosocomial infections and factors in patients in intensive care unit ( ICU) ,in order to provide a basis for the measures .Methods Using the method of target monitoring , to the patients who were in the ICU from January 2013 to December had a prospective surveillance , statistics and analysis the monitoring data .Results There were 163 cases happened nosocomial infection in 677 cases of patients, hospital infection rate was 24.1%;212 cases of secondary infection , infection cases rate was 31.3%. The main site of infection followed by respiratory tract ( 143 cases, 67.5%), blood (28 cases,13.2%), urinary tract (15 cases, 7.1%).The main pathogen of infection followed by Acinetobacter baumannii (64 strains, 30.2%), Pseudomonas aeruginosa (35 strains, 16.5%) and Klebsiella pneumoniae (24 strains, 11.3%).Different age, hospitalization, the number of disease diagnosis at ICU hospitalized , mechanical ventilation time and presence of detaining urethral catheter for endotracheal intubation , deep venous catheterization , indwelling catheters in patients with the incidence of comparative differences were statistically significant (P〈0.05)Conclusions Should take appropriate prevention and control measures for related factors of nosocomial infection in ICU , strict aseptic procedures and disinfection and isolation system , strengthen the hand hygiene , good management of invasive procedures , try to shorten the hospital stay of patients , rational use of antibiotics and so on are the key measures to reduce the nosocomial infections in ICU .
作者 高伟 武云静
出处 《中华现代护理杂志》 2014年第22期2784-2787,共4页 Chinese Journal of Modern Nursing
关键词 重症监护病房 医院感染 监测 相关因素 ICU Nosocomial infection Monitoring Relevant factors
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