老年高血压脑出血患者术后医院感染危险因素及预防干预研究  

Risk factors and prevention of nosocomial infections in elderly patients with hypertensive intracerebral hemorrhage

作　　者：邓丽萍[1] 李雪一[1] 龚龙飞[1] 肖菲娜[1] 王粤峰[1] 

机构地区：[1]中山大学附属第五医院神经外科,广东珠海519000

出　　处：《中华医院感染学杂志》2017年第19期4443-4445,4456,共4页Chinese Journal of Nosocomiology

摘　　要：目的研究老年高血压脑出血患者术后医院感染的相关危险因素并对其相关预防措施进行分析。方法选择2013年3月-2015年9月医院收治的560例高血压脑出血患者,详细记录患者临床资料,其相关因素进行单因素和多因素logistic回归分析,并分析感染病原菌。结果 560例高血压脑出血患者术后发生医院感染72例,感染率12.86%,感染96例次,例次感染率为17.14%,而例次感染中主要以下呼吸道感染、泌尿道感染以及颅内感染为主;患者年龄偏大、存在侵入性操作、GCS评分低、未给予经验性使用抗菌药物、白细胞计数升高、合并相关基础疾病及血清中白蛋白过低是影响患者发生医院感染的独立危险因素(P<0.05);96例次感染的患者共分离出病原菌112株,革兰阴性菌74株占66.07%,革兰阳性菌28株占25.00%,真菌10株占8.93%。结论依据相关危险因素在给予术后医院感染预防上一定要严格无菌操作、做好术前术后抗菌药物的使用及加强患者营养状态,对于降低老年高血压脑出血手术患者术后医院感染概率的发生有着重要作用。OBJECTIVE To investigate the risk factors of nosocomial infections in elderly patients with hypertensive cerebral hemorrhage,and to analyze the related preventive measures.METHODS A total of 560 patients with hypertensive intracerebral hemorrhage admitted in the hospital from Mar.2013 to Sep.2015 were enrolled in this study.The clinical data of the patients were recorded in detail.The related factors were analyzed by univariate and multivariable logisticregression analysis,and the pathogens were also analyzed.RESULTS There were 72 patients with nosocomial infections in 560 patients with hypertensive intracerebral hemorrhage,the infection rate was12.86%,and 96 cases were infected,with the infection rate of 17.14%.The main infection were respiratory tract infections,urinary tract infections and intracranial infections.The older age,invasive operation,low GCS score,no empirical use of antimicrobial agents,increased white blood cell count,combination with underlying diseases and low serum albumin were independent risk factors for nosocomial infections in patients（P〈0.05）.Totally 112 strains of pathogenic bacteria were isolated from 96 cases of infected patients,including 74 strains of gram-negative bacteria,28 strains of gram-positive bacteria,and 10 strains of fungi,accounting for 66.07%,25.00%,and8.93%,respectively.CONCLUSIONAccording to the relevant risk factors of nosocomial infections for post-operative prevention,it must be strictly aseptic operation,good preoperative and postoperative use of antibiotics and enhance the nutritional status of patients,which has an important role in reducing the incidence of nosocomial infections in elderly patients with hypertensive intracerebral hemorrhage.

关 键 词：老年 高血压脑出血 医院感染 危险因素 预防干预 

分 类 号：R651.12[医药卫生—外科学]