神经内外科175例医院感染危险因素的调查

目的　神经内外科是医院感染的高危科室之一 ,为了有效地降低医院感染发病率 ,提高医疗质量 ,对其医院感染的危险因素进行探讨。方法　对 2 0 0 0～ 2 0 0 1年两年间收治的 1796例住院患者进行前瞻性加回顾性的医院感染调查。结果　 1796例住院患者查出 175例医院感染 ,医院感染发病率为 9.74 % ,与我院总的医院感染率3.36 %相比差异有显著性 (P<0 .0 1) ;感染例次数为 2 2 2例 ,感染例次发病率为 12 .36 % ,与我院总感染例次发病率 3.94 %相比差异有显著性 (P<0 .0 1) ;感染部位的构成比以呼吸道为最高 ,第 2位是泌尿道 ;危险因素有原发性疾病危重、老年患者多、侵入性操作多、抗生素使用不合理 (二联使用率高达 6 6 .6 7% ,未进行药敏试验而按经验用药的达 5 6 % ) ;病原体以 G- 杆菌为主 (6 0 .36 % ) ,对多种抗生素耐药。结论　需采取综合性的防范措施才能有效地降低高危病区的医院感染发病率。

Nosocomial Infections in Departments of Neurology and Neurosurgery: Risk Factors Analysis of 175 Cases

OBJECTIVE To discuss the risk factors for nosocomial infection in departments of neurology and neurosurgery. METHODS Retrospective survey and prospective study were made for 1 796 inpatients in departments of neurology and neurosurgery from 2000 to 2001. RESULTS A total of 175 cases of nosocomial infection were found among 1 796 inpatients (the percentage was 9.74%). The main risk factors for nosocomial infection are related to the extent of disease seveity, age, medical invasive operation and unreasonable antibiotic therapy. The infection was located mostly in respiratory and urinary tracts. The etiological examination revealed that the major pathogens of nosocomial infection were Gram positive cocci (30.00%), fungi (6.31%) and Gram negative bacilli (60.36%) in neurosurgery. CONCLUSIONS The important methods to reduce nosocomial infection rate in departments of neurology and neurosurgery are to take all round reinforced measures.