老年骨科住院患者医院感染影响因素的研究  

Risk factors of nosocomial infections in elderly patients in department of orthopedics

作　　者：王小娟[1] 杨爱玲[1] 余霄[1] 黄丹凤 陈项琳 顾庆香 陆晓兰[3] WANG Xiao-juan;YANG Ai-ling;YU Xiao;HUANG Dan-feng;CHEN Xiang-lin;GU Qing-xiang;LU Xiao-lan(Ningbo Second Hospital,Ningbo,Zhejiang 315010,China)

机构地区：[1]宁波市第二医院骨科中心,浙江宁波315010 [2]宁波市第二医院康复科,浙江宁波315010 [3]宁波市第二医院口腔眼科,浙江宁波315010

出　　处：《中华医院感染学杂志》2018年第14期2155-2158,共4页Chinese Journal of Nosocomiology

基　　金：浙江省自然科学基金资助项目(2016079071)

摘　　要：目的分析老年骨科住院患者医院感染的影响因素,探讨预防医院感染措施,以期降低老年骨科住院患者医院感染率,提升患者预后质量。方法选取2015年11月-2016年11月医院收治的老年骨科住院患者328例,对患者临床基线资料(性别、年龄、体质量、体质量指数、合并基础疾病、肢体制动时间等)进行单因素及多因素Logistic回归分析,分析感染患者感染部位、感染病原菌构成情况,结合感染影响因素,探讨预防老年骨科住院患者医院感染对策。结果 328例患者中有35例医院感染,感染率为10.67%,以手术切口感染18例占51.43%为主,其次为呼吸系统感染12例占34.29%;多因素Logistic回归分析结果显示,老年骨科住院患者年龄>70岁、女性、BMI<18.0kg/m2、合并基础疾病、肢体制动时间>7d、手术治疗、侵入性操作次数>3次、有植入物、住院时间>14d、抗菌药物使用疗程>3个是发生医院感染的影响因素(P<0.05)。结论老年骨科住院患者医院感染的影响因素较多,临床医护过程中在加强人、机、料、法、环控制的同时,还应关注患者个体情况,采取针对性的治疗方案和康复方案,提升患者抵御病原菌侵袭的能力,降低患者发生医院感染的概率。OBJECTIVE To analyze the risk factors of nosocomial infections in elderly patients in department of orthopedics, and to explore measures to prevent nosocomial infections in order to reduce nosocomial infection rate and improve the quality of prognosis in patients. METHODS A total of 328 cases of elderly inpatients in department of orthopedics treated in the hospital from Nov. 2015 to Nov. 2016 were selected., The baseline clinical data （gender, age, weight, body mass index, with underlying diseases, limb braking time, etc.） of patients were analyzed by univariate analysis and multivariable logistic regression analysis. The nosocomial infection sites and the composition of pathogen infection of patients were analyzed, which combined with risk factors of infection to explore the preventive measures of infection in hospitalized patients in department of orthopedics. RESULTS Among the 328 cases of patients, 35 cases had nosocomial infections, and the infection rate was 10.67 %. The main infection site was the surgical incision infection, which was 18 cases accounting for 51.43 %, followed by the respiratory system infection, which was 12 cases accounting for 34.29%. Multivariable logistic regression analysis showed that the age of elderly patients in department of orthopedics 〉70 years old, female, BMI 〈18 kg/m2 , combination of underlying diseases, limb braking time. 〉7 d, surgical treatment, invasive operation times 〉3 times, implants, hospitalization time 〉14 d, and antibiotic use frequency 〉3 course of treatment were the influencing factors of nosocomial infection （P〈0.05）. CONCLUSION There are many risk factors of nosocomial infections in the elderly patients hospitalized in department of orthopedics. In the process of clinical treatment and nursing, the human, machine, material, method and environment control should be strengthened, and we also should pay attention to the individual patient, taking targeted treatment and rehabilitation programs, so as to improve patients ability to resist

关 键 词：老年骨科住院患者 医院感染 影响因素 病原菌 

分 类 号：R181.3[医药卫生—流行病学]