神经外科医院感染调查分析及护理对策  

Hospital Infection in the Neurosurgical Settings: An Investigation and Nursing Strategy

作　　者：刘冰[1] 张永琴[1] 贾淑梅[1] 顾克菊[1] 张红英[1] 

机构地区：[1]第四军医大学西京医院感染管理科,陕西西安710032

出　　处：《解放军护理杂志》2003年第4期35-37,共3页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的　探讨神经外科医院感染的危险因素 ,为制定护理对策提供依据。方法　采用前瞻性调查方法 ,分析我院神经外科 2 0 0 1年 4月 1日～ 9月 3 0日入院的 476例患者的医院感染情况。结果　感染发生率 15 .8% ,高于同期全院感染率 ( P<0 .0 1) ;脑出血和重度颅脑外伤患者的感染率分别为 2 3 .3 %和 2 4.4% ,高于肿瘤和其他类疾病感染率 ( P<0 .0 1) ;感染部位以下呼吸道、胃肠道和泌尿道多见 ;急诊入院、意识障碍、侵入性操作、使用糖皮质激素及H2 受体阻断剂和不合理使用抗生素与医院感染关系密切 ( P <0 .0 1)。结论　神经外科患者是医院感染的高危人群 ;脑出血和重度颅脑外伤患者是主要易感者 ;急诊入院、意识障碍、侵入性操作、使用糖皮质激素及H2 受体阻断剂和不合理使用抗生素是引起神经外科医院感染的危险因素。控制感染应针对上述因素 ,以综合预防和重点预防相结合 ,各种护理操作中严格无菌技术 。Objective:To investigate risk factors of hospital infection in the neurosurgical settings so as to decide corresponding nursing strategy.Methods A prospective study was performed to investigate hospital infection in the neurosurgical settings in 476 patients who were admitted into the Department of Neurosurgery from April 1st to September 30th , 2001.Results Incidence of hospital infection in the Department of Neurosurgery was 15.8%, higher than the overall incidence of hospital infection of the hospital (P<0.01). The incidence of hospital infection in brain hemorrhage cases or severe cerebral injury cases was 23.3% and 24.4% respectively, both higher than that in tumor cases or other diseases(P<0.01).Infections mainly involved the respiratory tract, gastrointestinal tract or urinary tract. The hospital infection was closely correlated with emergency hospitalization, unconsciousness, invasive manipulation, use of glucocorticoids or H 2 receptor inhibitors, and inappropriate use of antibiotics (P<0.01).Conclusion Patients in the neurosurgical settings are more likely to develop hospital infection. Emergency hospitalization, unconsciousness, invasive manipulation, use of glucocorticoid or H 2 receptor inhibitors, and inappropriate use of antibiotics are risk factors for hospital infection in the neurosurgical settings, which should arouse special attention in nursing care. Moreover, aseptic technique should be strictly adopted in nursing manipulations, and special attention should be paid to basic nursing and nursing of indwelling catheters, especially in critical patients.

关 键 词：神经外科 医院感染 调查分析 护理 对策 危险因素 

分 类 号：R651[医药卫生—外科学] R473.6[医药卫生—临床医学]