300例胃肠道手术患儿医院感染的调查分析

目的 研究分析胃肠道手术患儿医院感染的危险因素.方法 对2010年1月-2011年6月于医院进行胃肠道手术的300例患儿资料进行回顾性分析.结果 300例胃肠道手术患儿术后共发生13例医院感染,感染率为4.33％,以手术切口感染发生率最高,为7例,占53.85％,其次为下呼吸道、胃肠道及胸膜腔感染,分别占30.77％、7.69％、7.69％；对13例胃肠道手术医院感染患儿危险因素进行分析,结果显示,13例患儿均经验使用抗菌药物,而且种类＞2种,占100.0％,11例患儿留置尿管,占84.62％,手术时间＞120 min的患儿12例,占92.31％,急症手术的11例,占84.62％,以上危险因素具有代表性,差异有统计学意义(P＜0.05)；13例小儿胃肠道手术医院感染患儿共分离出13株病原菌,以革兰阴性菌为主,占61.54％,革兰阳性菌占30.77％,真菌占7.69％.结论 患儿年龄、手术种类、手术时间、麻醉方式等是引起患者医院感染的危险因素.

Research on nosocomial infections in 300 pediatric patients undergoing gastrointestinal surgery

OBJECTIVE To study and analyze the risk factors for nosocomial infections in pediatric patients undergoing gastrointestinal surgery.METHODS The clinical data of 300 pediatric patients who underwent gastrointestinal tract surgery from Jan 2010 to Jun 2011 were retrospectively analyzed.RESULTS Nosocomial infections occurred in 13 of 300 pediatric patients undergoing gastrointestinal tract surgery with the infection rate of 4.33%,the incidence of the surgical incision infections was the highest(7 cases,53.85%),followed by lower respiratory tract infections(30.77%),gastrointestinal infections(7.69%) and pleural space infections(7.69%);the result of the analysis of risk factors for nosocomial infections indicated that there were 13(100.0%)children who were with empirical use of more than two antibiotics,11(84.62%) children who were with indwelling catheter,12(92.31%) patients who were with the operation duration more than 120 min,and 11(84.62%) patients who underwent emergency surgery,the risk factors were representative,with statistical significance(P<0.05).Totally 13 strains of pathogens were isolated from the 13 pediatric patients,among which gram-negative bacteria accounted for 61.54%,gram-positive bacteria accounted for 30.77%,and fungi accounted for 7.69%.CONCLUSION The age,surgery type,operation duration,and anesthesia are the risk factors for nosocomial infections in the pediatric patients.