精神科封闭病房医院感染影响因素及防控对策  

Influencing factors for nosocomial infection in closed psychiatric ward and prevention countermeasures

作　　者：陈明菊[1] 李天萍[2] 刘先群[3] 高洁[4] 潘梅[5] 杨金华[6] CHEN Ming-ju;LI Tian-ping;LIU Xian-qun;GAO Jie;PAN Mei;YANG Jin-hua(Panzhihua Third People's Hospital,Panzhihua,Sichuan 617000,China)

机构地区：[1]攀枝花市第三人民医院老年内科,四川攀枝花617000 [2]攀枝花市第三人民医院感染科,四川攀枝花617000 [3]攀枝花市第三人民医院护理部,四川攀枝花617000 [4]攀枝花市第三人民医院老年精神科,四川攀枝花617000 [5]攀枝花市第三人民医院慢性精神科,四川攀枝花617000 [6]攀枝花市第三人民医院质量控制办公室,四川攀枝花617000

出　　处：《中华医院感染学杂志》2020年第1期146-150,共5页Chinese Journal of Nosocomiology

基　　金：四川省科技厅科技支撑计划基金项目(2016S38923)。

摘　　要：目的研究精神科封闭病房患者医院感染影响因素,并制定预防控制措施。方法选取2016年8月-2019年2月攀枝花市第三人民医院精神科封闭病房患者315例,回顾性分析患者临床资料,分析引起医院感染的病原菌,单因素及多因素Logistic回归模型分析患者发生医院感染的影响因素。结果 315例患者发生医院感染27例,感染率为8.57%;感染部位以呼吸道为主。临床因素中年龄、精神疾病类型、服用精神病药物种类、侵入性操作、保护性约束、手卫生管理、住院时间、病房环境消毒情况和辅助检查因素中血红蛋白、白蛋白水平、第1秒用力呼气容积(forced expiratory volume in one second,FEV1)与用力肺活量(forced vital capacity,FVC)比值为精神科封闭病房患者医院感染影响因素(P<0.05)。多因素Logistic回归模型显示精神疾病类型、服用精神病药物数量、侵入性操作、住院时间、低血红蛋白、白蛋白水平和FEV1/FVC比值均是导致精神科封闭病房医院感染的影响因素,保护性约束、手卫生管理、病房环境消毒是保护性因素。结论精神科封闭病房医院感染影响因素多样,而积极消除高危风险因素,利于预防病房感染,促进患者身心恢复。OBJECTIVE To explore the influencing factors for nosocomial infection in the patients of closed psychiatric ward and put forward the prevention countermeasures. METHODS A total of 315 patients who were hospitalized in the closed psychiatric wards of Panzhihua Third People′s Hospital from Aug 2016 to Feb 2019 were enrolled in the study, the clinical data of the patients were retrospectively analyzed, the pathogens causing the nosocomial infection were analyzed, and the univariate analysis and multivariate logistic regression analysis were performed for the influencing factors for the nosocomial infection. RESULTS Of the 315 patients, 27 had nosocomial infection, with the infection rate 8.57%;the patients with respiratory tract infection were dominant among the patients with nosocomial infection.The influencing factors for the nosocomial infection in the patients of closed psychiatric wards included the clinical factors such as age, types of mental illness, types of psychotropic drugs, invasive operation, protective restriction, hand hygiene management, length of hospital stay and disinfection in wards as well as the auxiliary examination factors such as hemoglobin, albumin and the ratio of forced expiratory volume in one second(FEV1)to forced vital capacity(FVC)(P<0.05).Multivariate logistic regression analysis showed that the types of mental illness, number of psychiatric drugs, invasive operation, length of hospital stay, low level of hemoglobin, low level of albumin and FEV1/FVC were the influencing factors for the nosocomial infection in the closed psychiatric wards, and the protective restriction, hand hygiene management and disinfection in wards were protective factors. CONCLUSION There are a variety of influencing factors for nosocomial infection in the closed psychiatric wards, and it is an effective way to eliminate the high-risk factors so as to prevent the infection and promote physical and mental recovery of the patients.

关 键 词：精神科 封闭病房 医院感染 危险因素 

分 类 号：R197.323[医药卫生—卫生事业管理]