新疆某三级甲等医院2364例神经外科手术患者医院感染危险因素  

Risk factors of nosocomial infection in 2364 neurosurgical patients admitted in a gradeⅢ,class A hosipital in Xinjiang

作　　者：张艳霞[1] 姚新宝[1] 田梅[1] 苏梅[1] 赵庆兰[1] 麦麦提依明·托合提 唐仕军 ZHANG Yanxia;YAO Xinbao;TIAN Mei;SU Mei;ZHAO Qinglan;MAIMAITIYIMING Tuoheti;TANG Shijun(Xinjiang Uygur Autonomous Region People's Hospital,Urumqi,Xinjiang 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院,新疆乌鲁木齐830001

出　　处：《现代疾病预防控制》2023年第3期170-174,190,共6页MODERN DISEASE CONTROL AND PREVENTION

摘　　要：目的 探讨神经外科手术患者医院感染发生的相关危险因素,为有效降低神经外科手术患者医院感染的发生提供理论依据。方法 回顾性调查2018-2021年新疆某三级甲等综合医院神经外科收治的手术患者中发生医院感染患者的一般情况、手术麻醉、医院感染和抗菌药物使用情况等,并采用logistic回归分析其危险因素。结果 2 364例神经外科手术患者中,发生医院感染227例,医院感染发病率为9.60%。感染部位以呼吸系统(121例,占45.32%)、手术部位(66例,占24.72%)、泌尿系统(32例,占11.99%)为主。单因素分析结果显示:合并糖尿病、合并高血压、术前低蛋白、术前住院天数、手术入路、美国麻醉师协会(ASA)评分、手术风险分级标准(NNIS)、手术类型、麻醉方式、手术持续时间、围手术期输血等差异有统计学意义(P<0.05);多因素logistic回归分析结果显示:合并高血压(OR=1.582,95%CI:1.031~2.427)、术前低蛋白(OR=4.873,95%CI:3.213~7.390)、术前住院日数≥7 d(OR=4.291,95%CI:2.731~6.742)、幕下手术入路(OR=1.857,95%CI:1.258~2.742)、围术期输血(OR=2.790,95%CI:1.728~4.504)、二次手术(OR=5.717,95%CI:3.686~8.868)和联合使用抗菌药物(OR=4.188,95%CI:2.672~6.564)是神经外科手术患者发生医院感染的危险因素,差异有统计学意义(P<0.05)。结论 低蛋白、术前住院时间长、二次手术、联合使用抗菌药物等是神经外科手术患者医院感染的主要危险因素。缩短术前住院天数,加强患者围术期管理,避免二次手术,合理规范使用抗菌药物在预防神经外科手术患者医院感染中可起到积极的作用。Objective To explore the risk factors of nosocomial infection in patients,and provide theoretical basis for effectively reducing the incidence of nosocomial infection in neurosurgical patients.Methods The general information,surgical anesthesia information,nosocomial infection information and antibacterial drug use of patients admitted to the neurosurgery department of a level-A tertiary general hospital in Xinjiang from 2018 to 2021 were retrospectively investigated,and the risk factors were analyzed by Logistic regression.Results A total of 2364 neurosurgical patients were investigated in this study,and 227 cases had nosocomial infection,with an incidence rate of 9.60%.The main sites of infection were respiratory system(121 cases,45.32%),surgical site(66 cases,24.72%)and urinary system(32 cases,11.99%).The results of the univariate analysis showed that having diabetes mellitus,having hypertension,preoperative hypoprotein,preoperative hospital stay(d),surgical approach,ASA score,NNIS grade,surgical type,anesthesia mode,duration of surgery(h),and perioperative blood transfusion were statistically significantly associated with nosocomial infection(P<0.05).Multivariate Logistic regression analysis showed that having hypertension(OR=1.582,95%CI:1.031-2.427),preoperative low protein(0R=4.873,95%CI:3.213-7.390),preoperative hospitalization≥7 days(OR=4.291,95%CI:2.731-6.742),under curtain surgical approach(OR=1.857,95%CI:1.258-2.742),perioperative blood transfusion(OR=2.790,95%CI:1.728-4.504),secondary surgery(OR=5.717,95%CI:3.686-8.868)and combined use of antibioticss(OR=4.188,95%Cl:2.672-6.564)were risk factors for nosocomial infection in neurosurgical patients,with statistical significance(P<0.05).Conclusions The main risk factors of nosocomial infection in neurosurgical patients are low protein,long preoperative hospital stay,second operation and combined use of antibiotics.Therefore,shortening the preoperative hospital stay,strengthening perioperative management of patients,avoiding second operation and rational

关 键 词：神经外科 手术 医院感染 危险因素 

分 类 号：R197[医药卫生—卫生事业管理]