慢性阻塞性肺疾病患者医院感染的危险因素分析  

Risk factors of nosocomial infections in chronic obstructive pulmonary disease patients

作　　者：李建玲[1] 雷琰[2] 杜云 

机构地区：[1]山东省公安消防总队医院门诊部,山东济南250101 [2]陕西中医学院第二附属医院呼吸内科,陕西西安712000 [3]陕西省妇幼保健院护理部,陕西西安710003

出　　处：《中华医院感染学杂志》2013年第22期5419-5420,5443,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(30171113)

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)患者医院感染的危险因素及预防控制措施。方法回顾性分析医院2009年5月-2010年3月收治的552例COPD医院感染患者临床资料,对COPD医院感染患者病历资料进行统一记录、分析,将差异有统计学意义的因素纳入多因素logistic回归分析。结果 552例COPD患者发生医院感染271例,感染率49.1%;单因素分析发现,住院时间、营养状况、抗菌药物使用种类、糖皮质激素使用及泌尿道插管,差异有统计学意义(P<0.05),多因素logistic回归分析显示,住院时间>2周、使用多种抗菌药物、使用糖皮质激素及行泌尿道插管是影响COPD患者医院感染的独立危险因素。结论应根据影响COPD患者医院感染的独立危险因素,尽量缩短住院时间、合理应用抗菌药物,确保雾化吸入及留置导管无菌操作,以降低感染风险,提高患者生存质量。OBJECTIVE To explore the risk factors of nosocomial infections in chronic obstructive pulmonary disease （COPD） patients so as to put forward prevention and control measures. METHODS The clinical data of 552 cases of COPD patients with nosocomial infections who were enrolled the hospital from May 2009 to Mar 2010 were retrospectively analyzed, then the medical records recorded in detail and analyzed,, then the factors with the of the COPD patients with nosocomial infections were statistical significance were screened out and included for multivariate logistic regression analysis. RESULTS Of totally 552 cases of COPD patients, the nosocomial infections occurred in 271 cases with the incidence rate of 49. 1%. The univariate analysis showed that the differences in the hospitalization duration, nutrition status, types of antibiotic used, use of glucocorticoid, or urinary catheterization was statistically significant （P〈0. 05）; the multivariate logistic regression analysis indicated that the length of hospital stay more than two weeks, use of multiple antibiotics, use of glucocorticoid, and urinary catheterization were the independent risk factors for the nosocomial infections among the COPD patients. CONCLUSION According to the independent risk factors, it is necessary to shorten the length of hospital stay, use antibiotics reasonably, ensure the aerosol inhalation, and perform aseptic catheterization so as to reduce the risk of infections and improve the life quality of the COPD patients.

关 键 词：慢性阻塞性肺疾病 医院感染 因素 分析 

分 类 号：R563.1[医药卫生—呼吸系统]