综合性ICU医院感染相关因素及直接经济损失研究  

Research on influencing factors and direct economic losses of nosocomial infection in integrated ICU

作　　者：王国恩[1] 王利[1] 刘敏龙[1] 马琪[1] 郭蕾[1] 刘媛媛[1] 王红梅[2] 

机构地区：[1]西安交通大学医学院第二附属医院重症医学科,陕西西安710004 [2]西安交通大学医学院第二附属医院感染办,陕西西安710004

出　　处：《中国医药导报》2015年第30期136-139,共4页China Medical Herald

基　　金：陕西省卫生厅科研基金项目(2012D65)

摘　　要：目的探讨综合性ICU医院感染相关因素及造成的直接经济损失。方法以2012年1月～2014年1月在西安交通大学医学院第二附属医院ICU住院的388例患者为研究对象，对其临床资料进行分析．并按条件进行1：1配比，发生医院感染的患者为病例组，未发生医院感染的患者为对照组，对比两组的住院费用。并分析医院感染的危险因素。结果388例患者中，发生医院感染140例，医院感染发生率为36．1％，其中，男109例，女31例，男性感染率（41．9％）明显高于女性（24．2％），差异有高度统计学意义（P〈0．01）。医院感染发生率随住院天数增加而增加，另外侵袭性操作、免疫抑制剂的使用与医院感染发生关系密切（P〈0．05）。140例感染病例中，共检出病原菌296株，革兰阴性菌212株，占71．6％，其中铜绿假单胞菌检出率最高为21．6％。病例组住院总费用中位数为91988．1元，对照组为31016．8元，病例组明显多于对照组，差异有统计学意义（P〈0．05），其中，药费支出最多，其次是治疗费，两组比较差异均有统计学意义（P〈0．05）。结论ICU患者是医院感染的高危人群，医院感染增加了医疗费用，造成了巨大的直接经济损失，应该加强ICU医院感染监控。Objective To analyze the related risk factors of nosocomial infection in ICU of general hospital and to eval- uate the direct economic loss by nosoeomial infection. Methods All the patients of ICU in the Second Affiliated Hospi- tal of Xi＇an Jiaotong University School of Medicine from January 2012 to January 2014 were collected. The clinical data of 388 cases were summarized. Patients with nosocomial infection were described as infection group and patients without nosocomial infection were described as control group. The patients of the two infections were paired according to the conditions at a ratio of 1：1. Based on the analysis of the clinical data, reasons causing the various risks of noso- comial infection were analyzed. Results 140 patients were suffered from nosocomial infection among 388 patients, the hospital infection rate was 36.1%. The infection rate of male was higher than female （41.9% vs 24.2%）, with statistical- ly significant difference （P 〈 0.01）. An increased rate of infection was associated longer length of stay, besides, invasive operation and immunosuppressant were closely related to nosocomial infection （P 〈 0.05）. Among 140 infected cases, 296 strains were detected of 212 strains were Gram-negative bacterium, accounted for 71.6%. Pseudomonas aeruginosa ranked first （21.6%）. The median of total hospitalization expenses were 91 988.1 and 31 016.8 yuan in infection and control group respectively, infection group was significantly higher than control group （P 〈 0.05）. The main increased expenses of hospitalization were medicine costs and therapy costs, the differences were statistically significant between the two groups （P 〈 0.05）. Conclusion The patients in ICU are susceptible population of nosocomial infection. Nosoco- mial infections of ICU patients during hospitalization caused significant increase in the medical expense, caused a huge direct economic losses. More attention should be paid to monitor the nosocomial infection.

关 键 词：综合性ICU 医院感染 经济损失 

分 类 号：R181.32[医药卫生—流行病学]