冠心病患者医院感染的危险因素分析及护理策略

目的分析冠心病患者发生医院感染的危险因素，探讨相应的护理策略以降低医院感染发生风险。方法收集1894例冠心病住院患者完整临床资料，分析医院感染发生情况和相关冈素。结果发生医院感染227例，医院感染率为11．99％。年龄≥60岁、病程≥10年、合并症≥2种、合并高血压、合并糖尿病、合并慢性阻塞性肺疾病、心功能分级高的患者医院感染发生率相对更高（P〈0．01），接受各类导管置人操作尤其是2种以上操作、接受有创治疗方式、使用人工呼吸机机械通气、责任护士年资较低、使用抗菌药物种类超过2种、抗菌药物应用时间≥15d、卧床时间和住院时间长的患者医院感染发生率相对更高（P〈0．01）。其中合并症≥2种、糖尿病、人工呼吸机机械通气、抗菌药物种类≥3种、卧床时间≥15d是冠心病患者医院感染的独立危险因素（P〈0．05）。结论合并多种慢性病尤其是糖尿病、使用人工呼吸机机械通气、应用多种抗生素治疗、长时间卧床等与冠心病患者医院感染发生直接相关。临床护理针对相关因素加强医院感染控制有助降低医院感染发生率。

Risk factors and nursing strategies of nosocomial infection in patients with coronary heart disease in hospital

Objective To analyze the risk factors of nosocomial infection in patients with coronary heart disease, dis- cuss the appropriate nursing strategies tO reduce the risk of nosocomial infection. Methods A total of 1 894 cases of hospitalized patients with coronary heart disease complete and related factors. Results The 227 cases of nosocomial clinical data, analyze the occurrence of hospital infection infection, hospital infection rate was 11.99%. Aged 360 years, ≥ 10 years duration, complications ≥2 species, hypertension, diabetes, chronic obstructive pulmonary disease, cardiac function in patients with high incidence of nosocomial infections were relatively higher （P〈0.01）, to accept particular types of catheter operation of two or more operations, receiving invasive treatment modalities, the use of arti- ficial breathing machine mechanical ventilation, the responsibility of nurses were low seniority, the use of more than two kinds of types of antimicrobial agents, antimicrobial agents time ≥15 d, bed time and length of hospital stay in patients with nosocomial infection rate were relatively higher （P〈0.01）. Which comorbidities ≥ 2 species, diabetes, ar- tificial breathing machine mechanical ventilation, antibiotics species ≥ 3 species, on bed time ≥ 15 d nosocomial in fection in patients with coronary heart disease were independent risk factors （P〈0.05）. Conclusion With multiple chron- ic diseases, especially diabetes, the use of artificial breathing machine mechanical ventilation, using a variety of an- tibiotics, such as prolonged bed rest in patients are directly related to with nosocomial infection in patient with coro- nary heart disease, clinical care for the related factors of hospital infection control helps to reduce hospital the inci- dence of infection.