神经内科重症监护室患者发生感染的影响因素分析  

Analysis of Influential Factors of Infection in Neurological Intensive Care Unit

作　　者：张健维[1] 姜彩娥[1] 李凯[1] 曹利波[1] 

机构地区：[1]河北邯郸市第一医院,河北邯郸056002

出　　处：《中国药房》2013年第22期2068-2070,共3页China Pharmacy

摘　　要：目的:探讨神经内科重症监护室(NICU)住院患者发生感染的特点及预防措施。方法:对2012年1-7月我院NICU中133例住院患者发生感染的临床资料进行回顾性调查分析。结果:133例NICU住院患者中,46例发生感染,感染发生率为34.6%;感染部位以下呼吸道为最常见,占91.3%,其次为泌尿道、胃肠道。共检出病原菌67株,其中革兰阴性菌51株,革兰阳性菌8株,真菌8株。年龄>60岁的患者感染率(36.6%)明显高于年龄≤60岁的患者(23.8%)(P<0.05);意识昏迷状态(100%)和留置胃管(42.1%)、留置尿管(40.2%)及气管插管、切开(100%)等因素使患者易感性增加(P<0.01)。结论:NICU住院患者是发生感染的高危人群,感染发生率高,危险因素较多且复杂,往往相互叠加起作用。应针对这些危险因素进行重点预防和控制,如减少侵入性操作,尽量缩短侵入性操作时间,缩短留置导管的时间;加强NICU环境管理,减少进出人员次数,严格执行消毒隔离制度及无菌技术操作原则;加强医务人员手卫生依从性。OBJECTIVE： To investigate the characteristics and prevention measures of inpatient infection in neurological inten- sive care unit （NICU）. METHODS： Clinical data of a total of 133 cases of inpatients infection in NICU from Jan, to Jul. in 2012 were analyzed retrospectively. RESULTS： There were 46 infection cases among 133 NICU inpatients, and the incidence of infec- tion was 34.6% ; lower respiratory tract infection was the most common, accounting for 91.3%, followed by the urinary tract and gastrointestinal tract. A total of 62 pathogens were detected, including 51 Gram-negative bacteria, 8 Gram-positive bacteria, 8 fun- gi. The infection rate （36.6%） of patients older than 60 was obviously higher than that （23.8%） of patients younger than 60 （P〈 0.05） ; conscious coma （100%）, indwelling stomach tube （42.1%）, catheter intubation （40.2%）, tracheal intubation, incision （100%） and other factors strengthened the susceptibility of patients （P〈0.01）. CONCLUSIONS： NICU hospitalized patients are in high risk of infection with a high incidence; the risk factors are more and complex, and they will paly the role by superimposing with each other. It should be key to prevent and control in view of these risk factors, such as reducing the invasive procedures, shortening invasive operation time, shortening the time of catheter. It is suggested to strengthen the management of NICU environ- ment, reduce the number of personnel in and out, strictly carry out disinfection and isolation system and principles of aseptic tech- nique and strengthen the hygiene compliance of medical staff.

关 键 词：神经内科 重症监护室 感染 危险因素 

分 类 号：R181.32[医药卫生—流行病学] R969.3[医药卫生—公共卫生与预防医学]