目标性监测对耳鼻咽喉头颈外科患者医院感染的预防效果研究  

Effect of targeted monitoring on prevention of nosocomial infections in patients of otolaryngology head and neck surgery department

作　　者：王令焕[1] 刘大响[1] 徐梅[1] 王秀珍[1] 高超[1] 吴晓欣[1] 

机构地区：[1]河北医科大学第四医院耳鼻喉科,河北石家庄050035

出　　处：《中华医院感染学杂志》2015年第10期2390-2392,共3页Chinese Journal of Nosocomiology

基　　金：河北省卫生厅医学科学研究基金资助项目(ZD20140393)

摘　　要：目的对耳鼻喉头颈外科患者医院感染进行目标性监测与分析,为临床预防感染提供依据。方法选取医院2012年2月-2013年12月收治的326例耳鼻咽喉头颈外科患者作为研究对象,采用目标性监测方法对患者的感染情况进行记录和分析,根据监测结果针对相关危险因素制定目标性干预措施,并选取2014年3-11月收治的158例患者作为研究对象,其中给予常规治疗的79例患者为对照组,另给予目标性干预措施的79例患者为干预组,对比两组患者治疗过程中医院感染情况,并对结果进行比较分析。结果 326例耳鼻咽喉头颈外科患者中发生医院感染49例,发生率为15.03%,其中以呼吸系统感染为主,占67.34%,其次为泌尿系统、循环系统和手术切口感染;共检出病原菌56株,其中革兰阴性菌39株占69.64%,革兰阳性菌9株占16.07%,真菌8株占14.29%;其中呼吸机使用、中心静脉导管置管以及留置导尿管3种侵入性操作的感染率分别为25.96%、5.95%和3.53%;干预组感染患者住院天数以及住院费用均较对照组明显减少,差异有统计学意义(P<0.05)。结论目标性监测能有效发现医院感染的影响因素,目标性干预措施则可有效地降低患者的医院感染率、住院天数以及治疗费用,对于改善医疗质量有着积极的作用。OBJECTIVE To conduct the targeted monitoring of nosocomial infections in patients of otolaryngology head and neck surgery department so as to provide guidance for clinical prevention of the infections .METHODS A total of 326 patients who were treated in the otolaryngology head and neck surgery from Feb 2012 to Dec 2013 were recruited as the study objects ,then the prevalence of infections was recorded and analyzed by means of the targeted monitoring method ,the targeted interventions were formulated according to the related risk factors .To‐tally 158 patients who were treated from Mar 2014 to Nov 2014 were enrolled in the study and divided into the control group with 79 cases and the intervention group with 79 cases ;the control group received the conventional therapy ,while the observation group received the targeted interventions ,and the prevalence of nosocomial infec‐tions during the treatment was observed and compared between the two groups .RESULTS The nosocomial infec‐tions occurred in 49 of 326 patients of otolaryngology head and neck surgery department ,with the incidence rate of 15 .03% ;the patients with respiratory system infections accounted for 67 .34% ,followed by the urinary system infections ,circulatory system infections ,and surgical incision infections .A total of 56 strains of pathogens have been isolated ,including 39 （69 .64% ） strains of gram‐negative bacteria ,9 （16 .07% ） strains of gram‐positive bac‐teria ,and 8 （14 .29% ） strains of fungi .The infection rate was 25 .96% in the patients who used ventilator ,5 .95%in the patients who underwent the central venous catheterization ,3 .53% in the patients who were given the urina‐ry catheter indwelling .Both the length of hospital stay and the hospitalization cost of the intervention group were significantly less than those of the control group（P〈0 .05） .CONCLUSION The targeted monitoring may help to find out the influencing factors for nosocomial infections ,and the targeted interventions can effectively redu

关 键 词：耳鼻咽喉头颈外科 医院感染 目标性监测 

分 类 号：R181.32[医药卫生—流行病学]