急性脑血管病死亡病例医院感染临床分析

目的 :探讨急性脑血管病 (ACVD)死亡患者医院感染及相关危险因素。方法 :对 1994年 12月 - 2 0 0 2年 12月在我院住院治疗的 2 5 2 0例急性脑血管病患者中死亡的 2 2 8例患者医院感染情况进行调查分析。结果 :住院期间死亡的 2 2 8例急性脑血管病患者中发生医院感染 6 2例 (2 7 2 % ) ,其中 12 7例脑出血患者发生医院感染 2 9例(2 2 8% ) ,10 1例脑梗死患者发生医院感染 33例 (32 7% )。 >6 0岁发生医院感染 39例 (6 3.0 % ) ,感染大多发生在住院的 2～ 2 0d ,部位以下呼吸道感染为主 (5 2 6 % ) ,其次为泌尿道感染 (2 4 .4 % ) ,引起医院感染的病原菌以G-菌和真菌为主 (41.7%、35 .4 % ) ,其次为G 菌 (2 2 .9% )。结论 :老年、意识障碍、住院日、侵袭性操作、泛用抗菌药物是导致医院感染的主要危险因素 ,对急性脑血管病患者在积极治疗基础疾病的同时特别要加强基础护理 ,针对各种相关危险因素采取有效综合防治措施。

Clinical Analysis of Nosocomial Infection in Dead Patients with Acute Cerebrovascular Disease

Objective: To evaluate the nosocomial infection and related risk factors of acute cerebrovascular disease (ACVD). Methods: 2520 patients with cerebrovascular disease who were hospitalized from December 1994 to December 2002 were studied retrospectively. Results: Two hundred and twenty-eight of 2520 patients were dead. Among them, 62 patients developed nosocomial infection with the infection rate being 27.2 %. There were 127 patients with cerebral hemorrhage, 101 with cerebral infarction and 60 at the age over 60, from them 22, 33, and 39 had nosocomial infection, respectively (the infection rates were 22.8 %, 32.7 %, 63 %, respectively). The onset time of infection was mainly on the day 2 to 20 after admission. The locations of infections was mainly in lower respiratory tract (52.56 %), followed by urinary tract (24.36 %). The main pathogens causing nosocomial infection were staphylococcus aureus, Acinetobacter spp and Kiebsiella pneumonia. Conclusion: The main risk factors for nosocomial infection were related to elderly, disturbance of consciousness, hospital stay, invasive operation and inappropriate use of antibacterial drugs. It is important to take effective steps to control nosocomial infection of ACVD.