心胸外科患者术后医院感染的调查及防治措施  

Investigation and analysis of nosocomial infections in patients of department of cardiothoracic surgery and prevention and treatment measures

作　　者：易凡[1] 陈宝钧[1] 李寻源[1] 赵轲[1] 

机构地区：[1]武汉市中心医院心胸外科,湖北武汉430000

出　　处：《中华医院感染学杂志》2014年第6期1484-1485,1488,共3页Chinese Journal of Nosocomiology

基　　金：吴阶平医学部基金会肝病医学部肝病实验诊断研究基金项目(LDWMF-PJ-2011A001)

摘　　要：目的调查分析医院心胸外科术后患者医院感染率、感染部位和感染危险因素,为临床防治工作总结有效的相关措施,以降低医院感染率。方法回顾性分析2007年2月-2012年10月心胸外科手术治疗患者1 587例,根据性别、年龄、基础疾病、手术持续时间、侵入性操作和住院时间等相关资料,统计医院感染率、感染部位和感染危险因素,总结有效防治措施,采用全自动微生物鉴定系统VITEK-32对送检标本进行细菌鉴定,采用SPSS13.0软件进行数据统计分析。结果心胸外科手术治疗1 587例患者发生医院感染125例,感染部位依次为上呼吸道49例、下呼吸道47例和胃肠道14例;医院感染病原菌主要为革兰阴性菌占68.0%,其中以铜绿假单胞菌和鲍氏不动杆菌分离率较高,分别占21.6%、19.2%,革兰阳性菌以金黄色葡萄球菌占11.2%,真菌以白色假丝酵母菌占6.4%;医院感染与年龄、基础疾病、手术时间、侵入性操作和住院时间均有相关性(P<0.05)。结论应规范诊疗工作,严格落实医院感染的各项管理制度,规范管理流程,避免心胸外科术后医院感染的发生,以确保医疗安全。OBJECTIVE To investigate the incidence of nosocomial infections, infection sites, and risk factors for infections in the patients of department of cardiothoracic surgery so as to put forward corresponding prevention measures and reduce the incidence of nosocomial infections. METHODS A total of 1 587 patients, who underwent surgery in the department of cardiothoracic surgery from Feb 2007 to Oct 2012, were enrolled in the study, then the incidence of nosocomial infections, infection sites, and risk factors for infections were statistically analyzed according to the related data, including the gender, age, underlying disease, operation duration, invasive operation, and length of hospital stay, the effective prevention measures were proposed, the bacterial identification of the strains isolated from submitted specimens was conducted by means of automatic microorganism identification system VITEK-32, and the statistical analysis was performed with the use of SPSS13.0 software. RESULTS Of the 1 587 patients, the nosocomial infections occurred in 125 cases, among which there were 49 cases of upper respiratory tract infections, 47 cases of lower respiratory tract infections, and 14 cases of gastrointestinal tract infections. Among the pathogens causing nosocomial infections, the gram negative bacteria accounted for 68.0 %, the Pseudomonas aeruginosa and Acinetobacter baurnannii were the predominant species of gramnegative bacteria, accounting for 21.6% and 19.2 %, respectively; the Staphylococcus aureus accounted for 11.2 % among the grampositive bacteria; the Candida albicans accounted for 6. 4% among the fungi. The incidence of nosocomial infections was related to the age, underlying disease, operation duration, invasive operation, or length of hospital stay（P〈0.05）. CONCLUSION It is necessary to standardize the diagnosis and treatment, strictly implement the infection control systems, and standardize the management process so as to prevent the postoperative infections and ensure the medical safety.

关 键 词：心胸外科 医院感染 防治措施 

分 类 号：R181.32[医药卫生—流行病学]