841例神经外科手术患者医院感染特征及危险因素分析

目的 研究神经外科手术患者医院感染情况,为制定医院感染控制措施提供理论依据.方法 采用目标性监测方法,对841例神经外科手术患者发生医院感染进行调查.结果 841例手术患者发生医院感染158例,感染率为18.79％；感染部位以手术部位感染为主,占37.14％,其次是下呼吸道感染,占29.14％；医院感染病原菌前3位依次为鲍氏不动杆菌、肺炎克雷伯菌及金黄色葡萄球菌,分别占25.00％、18.75％、15.63％；医院感染.的危险因素是手术患者原发疾病(神经系统肿瘤、脑出血)、麻醉分级、术前住院时间长、幕下手术入路、手术持续时间长、输血、气管插管/切开、使用呼吸机、泌尿道插管、住院时间长等.结论 神经外科手术患者医院感染危险因素多,需采取综合措施才能有效控制感染.

Characteristics and risk factors for nosocomial infections in 841 patients in department of neurosurgery

OBJECTIVE To investigate nosocomial infections in the patients undergoing the neurosurgical surgery and provide the theoretical bases for the control of nosocomial infections.METHODS A total of 841 cases of patients with nosocomial infections in department of neurosurgery were investigated by using the targeted monitoring method.RESULTS Totally 158 of 841(18.79%) patients occurred with nosocomial infections;the main infection site was surgical sites(37.14%),followed by low respiratory tract(29.14%);the top 3 of pathogens causing nosocomial infections were Acinetobacter baumanii(25.00%),Klebsiella pneumoniae(18.75%),and Staphylococcus aureus(15.63%);the primary diseases(nervous system neoplasms and cerebral hemorrhage),high ASA degree,long hospital stay before the surgery,subtentorial approach,the long duration of surgery,transfusion,trachea cannula and tracheotomy,mechanical ventilation,urinary catheterization and the long hospital stay were the risk factors for nosocomial infections.CONCLUSION There are many risk factors for nosocomial infections in the patients in the neurosurgical department,so the comprehensive measures should be taken to effectively control the infections.