危重症手足口病恢复期并植物状态患儿医院感染特点及防范研究  

Characteristics and prevention of nosocomial infection in children with severe hand foot and mouth disease and vegetative state

作　　者：吴值荣[1] 马彩云[1] 尚清[1] 刘冬芝 李靖婕[1] 张艳敏[1] 崔伟丽 WU Zhirong;MA Caiyun;SHANG Qing;LIU Dongzhi;LI Jingjie;ZHANG Yanmin;CUI WeiZi(Department of Rehabilitation,Children＇s Affiliated Hospital of Zhengzhou University,Children＇s Hospital of Henan,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院/河南省儿童医院康复医学科,河南郑州450000

出　　处：《中国实用神经疾病杂志》2018年第16期1804-1811,共8页Chinese Journal of Practical Nervous Diseases

基　　金：郑州市科学技术局课题(编号:20150168)

摘　　要：目的探讨(危)重症手足口病恢复期并植物状态患儿医院感染特点、影响因素,为(危)重症手足口病恢复期并植物状态患儿医院感染的早期痊愈提供临床依据。方法选取2011-01—2016-12郑州儿童医院收治的395例(危)重症手足口病恢复期并植物状态患儿中抽出230例作为研究对象,2011-01—2013-12共110例为对照组,2014-01—2016-12共120例为观察组。回顾性分析对照组病例中与医院感染发生高度相关影响因素的管理情况,并规范细化管理操作流程:营养支持(注重能量、维生素及矿物质的摄入)、坠积性肺炎的护理、侵入性导管的护理、口腔卫生、胃肠状态的调整、体位引流防呛咳、手卫生规范操作、家庭护理培训、医生的督促和重视、液体的补充、早期康复治疗量的控制、康复科一般护理常规,并提高这些相关因素在观察组患儿中的重视率及操作规范。比较对照组及观察组在医院感染痊愈的时间上及患儿入院后1个月内进行康复治疗的平均时间。结果 "营养支持(注重能量、维生素及矿物质的摄入)、坠积性肺炎的护理、侵入性导管的护理、口腔卫生、胃肠状态的调整、体位引流、手卫生规范操作、家庭护理培训、医生的督促和重视",这些因素是影响(危)重症手足口病并植物状态患儿医院感染顺利度过的关键因素。观察组患儿的医院感染痊愈时间明显短于对照组(P<0.05),入院后1个月内观察组患儿医院感染复发率明显低于对照组(P<0.05),观察组与对照组比较相同时间点观察组植物状态评分高于对照组(P<0.05);观察组患儿入院后1个月内进行康复训练的平均时间较对照组明显增多(P<0.05)。结论重视(危)重症手足口病恢复期并植物状态患儿的医院感染关键因素的管理,规范和细化操作流程,有助于减少医院感染时间,提高植物状态评分,利于早期康复介入,为康复治疗奠定良好的基�Objective To investigate the characteristics and influencing factors of hospital infection in children with severe hand,foot and mouth disease in recovery and vegetative state,and provide clinical evidence for the early recovery of hospital infection in children with severe hand,foot and mouth disease recovery.Methods A total of 395 cases of severe hand,foot and mouth disease recovery and vegetative state from the Children＇s Hospital of Zhengzhou University,which was admitted to the Children＇s Hospital of Zhengzhou University from January 2011 to December 2016,and 230 cases of children with vegetative state were selected as the research objects.A total of 110 cases from January 2011 to December 2013 were selected in the control group,120 cases from January 2014 to December 2016 were observation group.Retrospectively analyze the management of factors that are highly correlated with nosocomial infections in the control group,and standardize the management process：nutrition support（focus on energy,vitamin and mineral intake）,care of hypostatic pneumonia,invasion Sexual catheter care,oral hygiene,gastrointestinal status adjustment,position drainage prevention cough,hand hygiene standard operation,home care training,doctor＇s supervision and attention,fluid supplementation,early rehabilitation treatment volume control,rehabilitation department general care Routine,and improve the attention rate and operating practices of these related factors in the observation group of children.The average number of days in which the control group and the observation group were cured in the hospital and the average number of days of rehabilitation in the month after admission.Results Nutrition support（focus on energy,vitamin and mineral intake）,care for hypostatic pneumonia,care of invasive catheters,oral hygiene,adjustment of gastrointestinal status,positional drainage,hand hygiene practices,home care training,physician＇s supervision and attention,these factors are the key factors affecting the risk of（severe）se

关 键 词：(危)重症手足口病 植物状态 医院感染 神经系统后遗症 康复介入 

分 类 号：R512.5[医药卫生—内科学]