综合ICU医院感染目标性监测结果分析  

Target surveillance of nosocomial infections in comprehensive ICU

作　　者：张焱[1] 黄新玲[1] 何文英[1] 李新梅[1] 李静[1] 芦永华[1] 郑丽英[1] 

机构地区：[1]石河子大学医学院第一附属医院院感办,新疆石河子832008

出　　处：《农垦医学》2014年第2期149-151,共3页Journal of Nongken Medicine

摘　　要：目的:了解我院综合ICU医院感染发生状况及危险因素,为有效预防与控制医院感染提供依据。方法:采用目标性监测的方法,对入住ICU48小时后和出ICU48小时内的住院患者导尿管、中心静脉插管、呼吸机的使用和医院感染的情况进行监测分析。结果:综合ICU患者医院感染人次率和例次率分别为17.25%、21.88%,千日感染人次率和例次率分别为14.78‰、18.75‰;平均病情严重程度3.94分,调整后日感染人次率和例次率分别为3.75‰、4.76‰;总器械使用率为146.24%,其中导尿管、中心静脉插管、呼吸机的使用率分别为54.35%、50.59%、41.30%;相关的尿路感染、导管相关血流感染、呼吸机相关肺部感染的感染率为1.46‰、3.53‰、11.53‰。结论:3种侵入性操作是引发ICU医院感染的主要危险因素,因此ICU患者合理使用侵入性操作是预防和控制医院感染的重点,医院感染目标监测能及时获得医院感染的动态信息,为制定有效的干预措施提供依据。Objective：To understand the cu rrent status and risk factors of nosocomial infections in comprehensive ICU and provide evidence for prevention and control of nosocomial infections. Methods：Monitoring patients who admitted to ICU after 48 hours and discharge from ICU within 48 hours using target surveillance. Meanwhile analyzed the device utilization ratios and device associate infection ratios. Results：The occurrence rate of nosocomial infection in comprehensive ICU was 17.25% and the case rate was 21.88%, the daily occurrence rate of nosocomial infection was 14.78‰ and the case rate was 18.75‰; average severity of illness score was 3.94, nosocomial infection incidence per patient-day was 3.75‰ and the case rate was 4.76‰ after adjusting with ASIS method, total invasive device utilization ratios was 146.24%, invasive device utilization ratios of urethral catheter、central venous catheterization、respirator was 54.35%、50.59%、41.30% respectively, nosocomial infection rate of CAUTI、CRBSI、VAP was 1.46‰、3.53‰、11.53‰ respectively. Conclusion：The utilization of three invasive device was main risk factors for nosocomial infections in comprehensive ICU, the key of prevention and control of nosocomial infection in comprehensive ICU was rational utilization of invasive device. Target surveillance provide evidence for prevention and control of nosocomial infection in comprehensive ICU through acquired timely dynamic information of nosocomial infection.

关 键 词：重症监护 医院感染 目标监测 

分 类 号：R197.323.4[医药卫生—卫生事业管理]