ICU呼吸衰竭患者耐药菌感染发生的影响因素及护理对策  

Influencing Factors and Nursing Countermeasures of Drug-resistant Bacteria Infection in ICU Patients with Respiratory Failure

作　　者：施宏兰 周丽情 姚佳丽 郑美仙 SHI Honglan;ZHOU Liqing;YAO Jiali;ZHENG Meixian(Intensive Care Unit,Yongchun County Hospital,Quanzhou 362621,Fujian,China;General Surgery Departments,Yongchun County Hospital,Quanzhou 362621,Fujian,China)

机构地区：[1]永春县医院ICU,福建泉州362621 [2]永春县医院综合外科,福建泉州362621

出　　处：《中国药物滥用防治杂志》2024年第11期2004-2006,共3页Chinese Journal of Drug Abuse Prevention and Treatment

基　　金：吴阶平基金会资助项目(编号:320.6750.2021-08-7)。

摘　　要：目的:分析重症监护室(Intensive Care Unit,ICU)呼吸衰竭患者耐药菌感染发生的影响因素,并制定ICU呼吸衰竭患者耐药菌感染的预防性护理对策。方法:选取我院2021年1月—2024年1月的ICU呼吸衰竭合并耐药菌感染的40例患者进行回顾性分析,将其分为感染组,另选取同期40例未发生感染的ICU呼吸衰竭患者分为非感染组。分析感染组患者病原菌检出情况,并对比两组一般临床资料,采用Logistics回归模型分析影响因素。结果:感染组与非感染组性别、年龄、体质量指数(BMI)、ICU住院时间、吸烟情况比较,差异无统计学意义(P>0.05),感染组与非感染组气管插管、使用糖皮质激素、入住ICU前使用抗菌药物、APACHE-Ⅱ评分、留置胃管及合并呼吸系统疾病情况比较,差异有统计学意义(P<0.05);Logistics回归模型分析显示,气管插管(95%CI:1.321~3.564,OR:1.726)、入住ICU前使用抗菌药物(95%CI:1.353~5.782,OR:2.462)、APACHE-Ⅱ评分(95%CI:1.658~4.687,OR:2.789)、留置胃管(95%CI:1.657~5.648,OR:2.978)、合并呼吸系统疾病(95%CI:1.352~3.362,OR:2.142)为ICU呼吸衰竭患者耐药菌感染的主要影响因素(P<0.05)。结论:气管插管、入住ICU前使用抗菌药物、APACHE-Ⅱ评分、留置胃管、合并呼吸系统疾病与ICU呼吸衰竭患者耐药菌感染的发生密切相关,临床需制定相应预防性护理措施,预防耐药菌感染发生。Objective:To analyze the influencing factors of drug-resistant bacterial infection in patients with respiratory failure in the intensive care unit(ICU),and to formulate preventive nursing countermeasures for drug-resistant bacterial infection in patients with respiratory failure in ICU.Method:A retrospective analysis was performed on 40 patients with ICU respiratory failure and drug-resistant bacterial infection from January 2021 to January 2024,and 40 patients with ICU respiratory failure who did not develop infection during the same period were divided into the non-infection group.The detection of pathogenic bacteria in the infection group was analyzed,and the general clinical data of the two groups were compared,and the influencing factors were analyzed by Logistics regression model.Result:There were no significant differences in gender,age,body mass index(BMI),length of stay in ICU and smoking between the infection group and the non-infection group(P>0.05).There were significant differences in endotracheal intubation,use of glucocorticoids,use of antibiotics before admission to ICU,APACHE-Ⅱ score,indwelling gastric tube and respiratory diseases between the infection group and the non-infection group(P<0.05).Logistics regression model analysis shows.Tracheal intubation(95%CI:1.321-3.564,OR:1.726),use of antibiotics before admission to ICU(95%CI:1.353-5.782,OR:2.462),APACHE-Ⅱ score(95%CI:1.658-4.687,OR:2.789),indwelling gastric tube(95%CI:1.657-5.648,OR:2.978),combined respiratory diseases(95%CI:1.352-3.362,OR:2.142)were the main influencing factors of drugresistant bacterial infection in ICU patients with respiratory failure(P<0.05).Conclusion:Tracheal intubation,use of antibiotics before admission to ICU,APACHE-Ⅱ score,indwelling gastric tube,combined with respiratory diseases are closely related to the occurrence of drug-resistant bacteria infection in ICU patients with respiratory failure.It is necessary to formulate corresponding preventive nursing measures to prevent the occurrence of drug-resistant

关 键 词：呼吸衰竭 耐药菌感染 影响因素 护理对策 重症监护室 

分 类 号：R473[医药卫生—护理学]