循证研究对预防多发性骨髓瘤患者CRE感染的应用效果  

Application of evidence-based medicine in prevention of CRE infection in patients with multiple myeloma

作　　者：闫岩[1] 田颖[1] 耿传营[1] 张旭[1] YAN Yan;TIAN Ying;GENG Chuan-ying;ZHANG Xu(Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院血液科,北京100020

出　　处：《中华医院感染学杂志》2018年第23期3627-3630,共4页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81500164)

摘　　要：目的探讨循证研究对预防多发性骨髓瘤患者耐碳青霉烯类肠杆菌科细菌(CRE)感染的应用效果,以降低多发性骨髓瘤患者CRE发生率,提高患者生存质量。方法选取自2014年1月-2017年1月在医院治疗的多发性骨髓瘤患者196例为研究对象,将患者随机分为对照组及试验组,每组98例,对照组给予常规护理,试验组在常规护理的基础上对患者进行个体化循证护理,通过鱼骨图分析多发性骨髓瘤患者感染发生的主要原因,比较试验组和对照组患者多发性骨髓瘤患者CRE感染发生率与患者感染CRE的标本主要来源。结果试验组患者CRE感染发生率为1.02%,低于对照组患者7.14%(χ2=4.691,P=0.030);对照组CRE感染患者感染CRE的标本主要均来源于痰液,占57.14%(4/7),感染主要菌种为肺炎克雷伯菌,占57.14%(4/7);试验组CRE感染患者感染的标本来源为痰液,感染菌种为肺炎克雷伯菌。结论循证研究能有效预防控制多发性骨髓瘤患者CRE感染的发生,提高护理质量,进而提高患者生存质量,效果显著,值得在临床推广。OBJECTIVE To investigate the application of evidence-based medicine in prevention of carbapenem-resistant Enterobacteriaceae (CRE)infection in patients with multiple myeloma,thus reducing the incidence of CRE in patients with multiple myeloma and improving the survival quality of patients.METHODS A total of 196 patients with multiple myeloma treated in our hospital from Jan.2014 to Jan.2017 were randomly divided into two groups (n=98).The control group was given routine care,whereas the experimental group was given individualized evidence-based ursing on the basis of routine care.The main causes of infection in patients with multiple myeloma were analyzed by fishbone diagram.The incidence of CRE infection and the main source of CRE infection in patients with multiple myeloma were compared between the experimental group and the control group.RESULTS The incidence of CRE infection in the experimental group (1.020%)was significantly lower than that in the control group (7.142%)(P<0.05).The specimens with CRE infection in the patients of the control group were mainly from sp.utum,accounting for 57.14%(4/7),and the dominant pathogen was Klebsiella pneumonia,accounting for 57.14%(4/7).The source of specimens with CRE infection in the patients of the experimental group was also sputum,and the pathogen was also K pneumonia.CONCLUSION Evidence-based research can effectively prevent the occurrence of CRE infection in patients with multiple myeloma,improve the quality of care,and thus improve the quality of life of patients.The effect is significant,and it is worth promoting in the clinic.

关 键 词：循证医学 多发性骨髓瘤患者 耐碳青霉烯类肠杆菌科细菌 

分 类 号：R473.73[医药卫生—护理学]