高血压脑出血手术患者不同医院感染部位卫生经济学评价  

Health economics of different sites of nosocomial infections in hypertensive cerebral hemorrhage patients receiving surgical procedures

作　　者：田晓玲[1] 许红梅[2] 孙吉花[3] 李珍珠[4] 张涛[4] 赵倩倩 TIAN Xiao-ling;XU Hong-mei;SUN Ji-hua;LI Zhen-zhu;ZHANG Tao;ZHAO Qian-qian(Binzhou Medical University Hospital,Binzhou,Shandong 256603,China)

机构地区：[1]滨州医学院附属医院儿外科病区,山东滨州256603 [2]滨州医学院附属医院护理部,山东滨州256603 [3]滨州医学院附属医院院感办,山东滨州256603 [4]滨州医学院附属医院神经外科病区,山东滨州256603 [5]滨州医学院附属医院消化内科,山东滨州256603

出　　处：《中华医院感染学杂志》2018年第18期2848-2851,2860,共5页Chinese Journal of Nosocomiology

基　　金：山东省医药卫生科技发展计划基金资助项目(2015WS0491;2017WS754)

摘　　要：目的分析高血压脑出血手术患者不同医院感染部位延长的住院天数和增加的住院费用,为医院管理部门制定相关政策提供依据。方法回顾性分析某三级甲等医院2015-2016年神经外科病区272例高血压脑出血手术患者的临床资料,发生医院感染患者作为感染组,1∶1条件配比后筛选出对照组,两组患者住院费用和住院天数的平均水平用中位数描述,经济损失的比较采用秩和检验。结果 272例高血压脑出血手术患者中,医院感染发生率为20.96%(57/272),医院感染例次发生率为25.37%(69/272);感染部位以下呼吸道为主占59.42%(41/69);不同医院感染部位导致直接经济损失不同(P<0.05),下呼吸道感染的患者直接经济损失最多。不同年龄段患者,感染组较对照组增加的住院费用及住院时间比较差异有统计学意义(P<0.05)。结论高血压脑出血手术患者下呼吸道感染导致住院费用增加、住院时间延长,直接经济损失最多,应有效控制下呼吸道感染的发生。OBJECTIVE To explore the extension of hospitalization duration and increase of hospitalization cost due to different sites of nosocomial infections in the hypertensive cerebral hemorrhage patients receiving surgical procedures so as to provide guidance for development of related policies.METHODS The clinical data of 272 patients with hypertensive cerebral hemorrhage who received surgical procedures in wards of neurosurgery department of a three-a hospital from 2015 to 2016 were retrospectively analyzed,the patients who had nosocomial infections were assigned as the infection group,the patients were screened out in a 1：1 conditional matching ratio and were set as the control group.The mean hospitalization cost and hospitalization duration were defined as median,and the economic loss was compared by using rank sum test.RESULTS Of the 272 hypertensive cerebral hemorrhage patients undergoing the surgical procedures,the incidence rate of nosocomial infection was 20.96%（57/272）,the case-time infection rate was 25.37%（69/272）;the patients with lower respiratory tract infection were dominant,accounting for 59.42%（41/69）.The different sites of infection led to different direct economic losses（P〈0.05）.The direct economic loss was the greatest in the patients with lower respiratory tract infection.For the different age groups of patients,there were significant differences in the increase of hospitalization cost and the extension of hospitalization duration between the infection group and the control group（P〈0.05）.CONCLUSION The lower respiratory tract infection in the patients with hypertensive cerebral hemorrhage may lead to the increase of hospitalization cost and the extension of hospitalization duration,with the direct economic loss greatest.It is necessary to effectively control the lower respiratory tract infections.

关 键 词：高血压脑出血 医院感染 经济损失 

分 类 号：R619[医药卫生—外科学]