老年心力衰竭患者发生医院感染对预后的影响研究  

Impact on the prognosis of elderly patients with heart failure nosocomial infections

作　　者：于安忠[1] 张景遥[2] 刘兵[1] 张秀杰[1] 高绍喜[1] 

机构地区：[1]济南市第四人民医院心血管二科,山东济南250031 [2]济南市传染病医院血液净化科,山东济南250021

出　　处：《中华医院感染学杂志》2016年第8期1764-1766,共3页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(SD28187723)

摘　　要：目的探讨老年心力衰竭患者发生医院感染对预后的影响,提高对患者医院感染的重视,降低医院感染发生率。方法选择2013年1月-2015年8月于医院接受治疗的898例心力衰竭患者,按照是否发生医院感染将患者分为感染组102例与未感染组796例,分析病原菌分布、药敏试验及发生医院感染对预后的影响,数据采用SPSS 18.0软件进行统计分析。结果共检出112株病原菌,以革兰阴性菌为主,共68株占60.71%;革兰阴性菌中铜绿假单胞菌对头孢曲松及磺胺甲噁唑/甲氧苄啶具有较高的耐药性;非感染组患者KPS评分、住院时间均优于感染组;非感染组患者治疗总有效率为91.58%,感染组为78.43%,两组比较差异均有统计学意义(P<0.05)。结论治疗老年心力衰竭医院感染时要合理选择抗菌药物,并及时进行细菌培养和药敏试验;降低患者KPS评分、治疗有效率及住院时间。OBJECTIVE To investigate the occurrence of hospital infections in elderly patients with heart failure prognostic impact,to increase more attention for patients with nosocomial infections,and to reduce hospital infection rates.METHODS A total of 898 cases of heart failure patients from Jan.2013 to Aug.2015 in our hospital were selected,including patients with 102 cases of nosocomial infections and 796 cases of nosocomial infections.Pathogen distribution,susceptibility testing and impact of infection on prognosis were studied,and the results were statistically analyzed with software SPSS 18.0.RESULTS A total of 112 pathogens were detected,of which68gram-negative bacteria accounted for 60.71%.Pseudomonas aeruginosa to ceftriaxone and sulfamethoxazole had a high resistance.The KPS score and hospital stay in non-infected group were better than that of the infection group.The total effective rate of treatment of non-infected group was 91.58%,while the rate of the infected group was 78.43%,and the difference was significant（P〈0.05）.CONCLUSIONIn the treatment of heart failure in elderly hospital infection,antimicrobial drugs should be chosen properly,and timely bacterial culture and sensitivity test are necessary so as to reduce the KPS score,effective rate of treatment,and length of hospital stay.

关 键 词：心力衰竭 医院感染 细菌培养 预后影响 

分 类 号：R541.6[医药卫生—心血管疾病]