中药封包联合集束化环境院感管理对院内肺部感染风险的影响  

Effectiveness of herbal medicine sealing therapy combined with bundle infection management in reducing the risk of nosocomial pulmonary infection

作　　者：张蕴 张淑芳 骆红微 ZHANG Yun;ZHANG Shufang;LUO Hongwei(Department of Infection Management,Baoding No.2 Central Hospital,Baoding,Hebei 072750;Hospital Infection Management Office,Baoding No.1 Hospital of TCM,Baoding,Hebei 071000;Department of Orthopedics of Traditional Chinese Medicine,Gao Bei Dian De Ren Hospital,Baoding,Hebei 074000)

机构地区：[1]河北省保定市第二中心医院感染管理科,河北保定072750 [2]河北省保定市第一中医院医院感染管理办公室,河北保定071000 [3]河北省高碑店德仁医院中医骨伤科门诊,河北保定074000

出　　处：《河北中医》2024年第6期971-975,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省保定市科研计划项目(编号:1951ZF032)。

摘　　要：目的观察中药封包联合集束化环境院感管理降低院内肺部感染风险的临床效果。方法将150例重症监护室(ICU)机械通气患者按照随机数字表法分为2组,对照组75例予常规院内环境管理,干预组75例在对照组基础上加中药封包联合集束化环境院感管理,持续干预至患者转出ICU。比较2组肺部感染率、28天死亡率、机械通气时间、ICU入住时间;比较2组临床肺部感染量表(CPIS)评分、英国胸科协会改良肺炎量表(CURB-65)评分变化;比较2干预后高频接触物体表面消毒效果;比较2组空气菌落数、消毒5 h后菌落数;比较2组清洁人员环境清洁认知得分。结果干预组肺部感染率、28天死亡率、机械通气时间、ICU入院时间均低于对照组(P<0.05)。干预组CPIS评分、CURB-65评分均低于对照组(P<0.05)。干预组干预后高频接触物体表面消毒合格率高于对照组(P<0.05)。干预组空气菌落数、消毒5 h后菌落数均少于对照组(P<0.05)。干预组清洁人员环境清洁认知得分高于对照组(P<0.05)。结论中药封包联合集束化环境院感管理,能提高环境清洁质量,降低院内肺部感染发生风险及严重程度,还可提高清洁人员的环境清洁认知水平。Objective To observe the effectiveness of herbal medicine sealing therapy combined with bundle infection management in reducing the risk of nosocomial pulmonary infection(NPI).Methods A total of 150 patients receiving mechanical ventilation admitted to intensive care unit(ICU)were randomly assigned into control group(n=75)and intervention group(n=75).All patients were managed by routine infection management schemes,and those in intervention group additionally received herbal medicine sealing therapy combined with bundle infection management.The intervention continued until the transfer out of ICU.The aim was to compare pulmonary infection rate,28-day mortality,mechanical ventilation duration,ICU hospitalization time,clinical pulmonary infection score(CPIS),CURB-65(confusion,uremia,respiratory rate,blood pressure,age 65 years)score,quality rate of surface disinfection of high-frequency objects,numbers of air bacteria at hours 0 and 5 of disinfection,cognitive level of environmental cleaning in cleaning staff between groups.Results Patients in the intervention group presented significantly lower pulmonary infection rate,28-day mortality,mechanical ventilation duration,and ICU hospitalization time(P<0.05).Patients in the intervention group had significantly lower CPIS and CURB-65 scores,significantly higher quality rate of surface disinfection of high-frequency objects,significantly lower numbers of air bacteria at hours 0 and 5 of disinfection(P<0.05).The cognitive level of environmental cleaning in cleaning staff were significantly higher than those of control group(P<0.05).Conclusion The herbal medicine sealing therapy combined with infection management bundle can improve the quality of environmental cleaning,reduce the risk and severity of NPI,and improve cognitive level of environmental cleaning in cleaning staff.

关 键 词：感染 肺 中药疗法 组织和管理 交叉感染 

分 类 号：R-36[医药卫生] R283