急性心肌梗死住院患者发生医院感染的相关危险因素分析  

Risk factors of nosocomial infections in hospitalized patients with acute myocardial infarction

作　　者：陈志刚[1] 赵金英[1] 岳兵[1] 关慧灵[1] 刘辉[1] 

机构地区：[1]新乡医学院第一附属医院心内科,河南卫辉453100

出　　处：《中华医院感染学杂志》2013年第11期2561-2563,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨急性心肌梗死住院患者发生医院感染的相关危险因素,为临床控制医院感染提供依据。方法回顾性分析331例急性心肌梗死住院患者临床资料,对相关危险因素进行分析。结果发生医院感染72例,感染率21.75%,感染部位主要为下呼吸道、泌尿系、胃肠道、上呼吸道及其他部位,分别占55.56%、16.67%、13.89%、6.94%及6.94%;患者年龄、合并高血压、合并糖尿病、合并肺部疾病、意识障碍、心力衰竭、心律失常、留置导尿、鼻饲、气管插管、使用呼吸机、预防用抗菌药物、使用H2阻滞剂及住院时间≥20d等因素是引起急性心肌梗死患者发生医院感染的相关因素(P<0.01);多因素logistic回归分析显示,心力衰竭、留置导尿、预防用抗菌药物、气管插管、使用呼吸机、住院时间长是引起急性心肌梗死住院患者发生医院感染的独立危险因素。结论急性心肌梗死住院患者医院感染发生率高,医院感染是多因素综合作用所致,应针对危险因素进行干预以预防及控制医院感染的发生。OBJECTIVE To study the risk factors of nosocomial infections in the hospitalized patients with acute myocardial infarction so as to provide basis for the clinical control of nosocomial infections. METHODS The medical records of 331 cases of hospitalized patients with acute myocardial infarction were retrospectively analyzed, and the related risk factors were analyzed. RESULTS The noscomial infections occurred in 72 cases with the infection rate of 21.75 %. The lower respiratory tract, urinary tract, gastrointestinal tract, upper respiratory tract infection, and the other sites were the main infection sites, accounting for 55.56%, 16.67%, 13.89%, 6.94%, and 6. 94%, respectively. The complication of high blood pressure, age, complication of diabetes mellitus, complication of lung disease, disturbance of consciousness, heart failure, arrhythmia, indwelling catheterization, nasal feeding, endotracheal intubation, use of ventilator, prophylactic use of antimicrobial agents, use of Hz blockers, and length of hospital stay more than 20 days were risk factors associated with the nosocomial infections in the patients with acute myocardial infarction （P〈0. 01）, while the multivariate logistic regression analysis showed that the heart failure, indwelling catheter, prophylactic use of antibacterial drugs, endotracheal intuba-tion, use of ventilator, and long-term hospital stay were the independent risk factors of the nosocomial infections in the hospitalized patients with acute myocardial infarction. CONCLUSION The incidence of the nosocomial infec-tions is high in the hospitalized patients with acute myocardial infarction, and the nosocomial infections are influ-enced under the comprehensive effect of multiple factors, it is necessary to take corresponding prevention and con- trol interventions according to the risk factors.

关 键 词：急性心肌梗死 医院感染 危险因素 

分 类 号：R542.22[医药卫生—心血管疾病]