产科医院感染危险因素前瞻性调查分析

目的通过前瞻性监测，探讨影响围生期产科医院感染的相关因素，采取相应措施，控制围产期产科医院感染发生率。方法以2004年5月--2005年5月住院产妇（包括顺产、剖宫产）、新生儿为调查对象，制定相关的调查表，内容包括：产妇阴道分泌物检查、HIV初筛、新生儿护理用品的管理、切口的护理、抗生素使用的管理、无菌物品的管理、产房的管理，院感专职人员每天到病房对上述各项院感的危险因素进行追踪、监督、管理、干预。结果调查期间的产科医院感染率控制在0．3％以下，与2003年5月--2004年5月的感染率0．9％相比明显下降，经X2检验，P〈0．05，差异有统计学意义，无一例新生儿发生医院感染。各环境类别监测扣无茵物品监测合格率大大提高。结论开展产科医院感染的前瞻性调查，对控制产科的医院感染的效果显著，故医院感染的监测应在综合性监测的基础上结合本院的实际情况，对其他院感的危险因素也推行靶位的前瞻性监洲、调查，以主动的前瞻性监测取代被动的回顾性监测，提高监控效率。

PROSPECTIVE STUDY AND ANALYSIS ON RISK FACTORS OF OBSTETRIC NOSOCOMIAL INFECTION

Objective To explore the impact factors of perinata infection in obstetric hospital, and to control hospital infection. Methods Puerperants （including by spontaneous labor or uterineincision delivery）and newborn infants were questionaired from May 2004 to May 2005. The data on examination of vaginal discharge, HIV screening, management of newborn care supplies, incision nursing, management of antibiotic use and sterile items, and maternity management were collected and analyzed. Monitoring, management and intervention were carried on the corresponding risk factors by specific fulltime staff everyday. Results The rate of hospital infection was 0.3% or less in this period, and had a remarkable drop more than 0.9 % from May 2003 to May 2004 （P〈0.05）. None of newborn hospital infection was found. Passing rate of various environmental and aseptic types of items increased substantially by monitor. Conclusion Prospective study and analysis on risk factors of obstetric nosoeomial infection has significant effect in the control of hospital infection.