重症脑卒中并发医院感染危险因素临床分析及预防

目的探讨重症脑卒中并发医院感染危险因素的临床特点，以便采取更加有效的控制措施降低其发生率。方法对湛江中心人民医院2005年1月-2008年11月住院的重症脑卒中并发医院感染病例进行回顾性调查分析。结果776例重症脑卒中并发医院感染148例，感染率为19．1％。重症脑卒中患者发生医院感染的危险因素包括意识障碍、假性延髓麻痹、侵袭性操作、原有的基础疾病（慢性支气管炎、糖尿病等），以及年龄、住院时间、抗生素的使用是否合理等。重症脑卒中并发医院感染的部位以呼吸道、泌尿道、胃肠道、血液、切口及皮肤黏膜等为主，主要病原体为革兰氏阴性菌，其次为革兰氏阳性菌和真菌。结论重症脑卒中并发医院感染病情严重，病死率增高，必须控制危险因素，才能有效地预防医院感染的发生。

Clinical Analysis and Prevention of Serious Stroke Complicated the Inhospital Infection

Objective To explore clinical characteristics for serious stroke and infective complication danger factor of the hospital so as take effective measure to control and reduce its occurrence rate. Methods Recall and survey analysis were performed for the serious patients suffered from the stroke and complication infection in Zhanjiang Center Peoples＇ Hospital from January 2005 to November 2008. Results One hundred and forty eight cases of stroke showed complicated hospital infection among 776 cases with rate of 19.1%. The infection occurrence of danger factors in the patients with stroke included mentality barrier, false medulla paralysis, attack operation,original basic disease （chronic bronchitis,diabetes etc）,age,period of staying in hospital and using antibiotic correct or not. The stroke and complication hospital infection sites were in tract, uropoiesis,gastrointestinal tract, blood, cutting opening and skin membrane mainly. Main etiology was Gram-negative bacteria and others were Gram-positive bacteria and fungus. Conclusion The patients suffered from serious stroke and complication hospital infection showed high death rate. Should the dangerous factor be controlled, the patients were prevented from hospital infection occurrence effectively.