呼吸重症监护室患者医院感染原因分析及预防对策

目的 分析呼吸重症监护室（RICU）住院患者医院感染相关原因,并提出预防对策.方法 回顾性分析首都医科大学附属北京胸科医院2010年1月至2013年1月RICU 890例住院患者的病历资料,分析RICU住院患者医院感染部位、病原菌分布和感染相关因素,并提出感染预防对策.结果 890例住院患者中有96例发生医院感染,感染发生率为10.8％.其中,多发于呼吸道感染65例,占67.7％;切口感染14例,占14.6％;泌尿道感染11例,占11.5％;引流管处感染4例,占4.2％;胃肠道感染2例,占2.1％.共分离鉴定128株病原菌,其中,革兰阴性菌78株,占60.9％;革兰阳性菌13株,占10.2％;真菌37株,占28.9％.RICU医院感染与患者性别无关（P＞0.05）,与患者年龄、机械通气时间、住院时间以及与否静脉置管、气管插管和尿道插管等相关（P＜0.05）.结论 RICU医院感染与多种因素相关,结合患者个体情况和感染相关因素采取有效的防治措施,可降低RICU患者医院感染率.

Analysis of cause and preventive methods of hospital infection in respiration intensive care unit

Objective To analyze the relative factors of hospital infection in respiration intensive care unit （RICU） hospitalized patients.Methods Relevant clinical data of 890 patients were analyzed retrospectively.The infected site,distribution of pathogenic bacteria,risk factors and preventive measures of patients were analyzed.Infection prevention methods were observed.Results There were 96 patients of hospital infection and the infected rate was 10.8% （96/890）.The infection included respiratory tract infection （65 cases,67.7 %）,infection of incisional wound （14 cases,14.6%）,urinary tract （11 cases,11.5%）,drainage tube （4 cases,4.2%） and gastrointestinal tract （2 cases,2.1%）.128 strains of pathogenic bacteria were isolated and identified,including gram-negative bacterium （78 strains,60.9%）,gram positive bacteria （13 strains,10.2%） and fungus （37 strains,28.9%）.There was no correlation between hospital infection of RICU and gender （P 〉 0.05） ; there was a correlation omong age,mechanical ventilation time,length of hospital stay,venipuncture or not,trachea cannula and intraurethral cannula （P 〈 0.05）.Conclusion The hospital infection in RICU is related with appropriate preventive treatment.