糖尿病患者合并医院感染的临床特征分析

目的 探讨糖尿病患者医院感染的临床特征及预防措施.方法 回顾性分析1020例糖尿病患者的临床资料.结果 医院感染发生率10.78%(110/1020);以呼吸道感染46例次最高;单部位感染50例,2个部位18例,3个及3个以上部位6例;具有相关系统感染典型表现72例,38例症状不典型;病原学检查送检率为73.64%(81/110);病原微生物检出率为66.67%(54/81);年龄大、女性、病程长、血糖控制差、侵袭性操作、合并其他疾病、存在并发症、肾衰竭期、住院时间长易发生医院感染;预防性应用抗生素不能降低医院感染发生率;发生医院感染患者病死率(5.45%,6/110)高于无医院感染患者(1.54%,14/910).结论 糖尿病患者医院感染率高,可加重病情,必须积极治疗原发病,保护易感染人群,提高患者自身免疫力;合理应用抗生素,尽早寻求细菌学及药敏试验依据;严格执行无菌操作,减少侵袭性操作;缩短住院时间.

The analysis of clinical features of diabetes mellitus patients with hospital infection

Objective To discuss the clinical features and prevention methods of the diabetes meilitus patients with hospital infection. Method Retrospectively, clinical data of 1020 patients with diabetes mellitus from January 2006 to December 2008 were analyzed. Results The occurrence rate of hospital infection was 10.78%(110/1020),46 cases with respiratory infection, 50 cases with single part infected, 18 cases with two parts infected, 6 cases with three or over three parts infected. There were 72 cases with typical infection and 38 cases with non-typical infection. 73.64% (81/110) patients underwent etiological examination. Pathogenic micro-organisms was detected in 66.67%(54/81) patients. The related factors of hospital infection were old age, female, long course of disease, poor glucose control, invasive operation, combination with other diseases, existence of complications, renal failure stage and long course of hospitalization. Antibiotics could not reduce the hospital infection. Fatality rate of infection patients was higher than that of non-infected patients (5.45%, 6/110 vs 1.54%, 14/910). Conclusions Diabetes mellitus patients have higher hospital infection, which can aggravate the illness. So doctors must cure the primary disease actively, protect the easily affected people, enhance the patients' immunity, use antibiotics rationally, seek the basis of bacteriology and do drug sensitivity test as soon as possible. Doctors should make aseptic implementation strictly, reduce invasive operation and shorten the time of hospitalization.