经内镜逆行胰胆管造影术后医院感染调查分析及干预措施

目的 了解经内镜逆行胰胆管造影(ERCP)术后患者医院感染的特点,分析易感因素,采取针对性的干预措施,以利医院感染的预防和控制.方法 采用回顾性调查方法,对2010年1-12月消化内科所有行ERCP手术的住院患者医院感染发生情况进行调查分析.结果 消化内科2010年行ERCP手术的患者共99例,发生医院感染10例,医院感染发生率为10.1％,医院感染部位以呼吸道感染为首,占38.4％,其次是血液感染,占23.1％;医院感染的发生与住院时间、年龄、基础疾病、内镜的清洗消毒密切相关;10例医院感染病例中检出病原菌3株,其中铜绿假单胞菌2株,金黄色葡萄球菌1株.结论 ERCP手术是相对有创的操作,且行ERCP手术的患者多为高龄、基础疾病较多、免疫力相对低下,因此,发生医院感染的机会也增多,只有采取针对性措施,才能降低其感染发生率.

Nosocomial infections after endoscopic retrograde cholangiopancreatography and intervention measures

OBJECTIVE To understand the features of nosocomial infections after endoscopic retrograde cholangiopancreatography(ERCP) and analyze the predisposing risk factors so as to take targeted interventions to facilitate the prevention and control of hospital infections.METHODS By the means of retrospective survey,the outbreak of nosocomial infections in the hospitalized patients who underwent ERCP in gastroenterology department from Jan to Dec 2010 was analyzed.RESULTS Of totally 99 patients who underwent ERCP in gastroenterology department in 2010,nosocomial infections occurred in 10 cases with the incidence rate of 10.1%.Respiratory tract was the major infection site,accounting for 38.4%,followed by the septicemia(23.1%).Nosocomial infection was closely related to the hospital stay,age,underlying diseases,and the cleaning and disinfection of endoscope;there were totally 3 strains of pathogenic bacteria isolated from 10 patients,including 2 strains of Pseudomonas aeruginosa and 1 strain of Staphylococcus aureus.CONCLUSION ERCP is a relatively invasive surgical operation,and the patients are mostly the elderly people with complex underlying diseases and low immunity.These factors make nosocomial infection increases,therefore,only to take the targeted measures can we decrease the incidence of nosocomial infections.