新生儿医院感染的危险因素及集束化护理干预效果

目的 探讨新生儿医院感染的危险因素及集束化护理干预效果,为临床治疗提供参考依据。 方法 选取海南省妇幼保健院收治的826例新生儿,根据其是否发生医院感染分为医院感染组(52例)和非医院感染组(774例),应用单因素及多因素Logistic回归分析新生儿医院感染的危险因素。将52例医院感染患儿随机分为对照组和观察组各26例,对照组给予常规护理,观察组在常规护理基础上采取集束化护理,比较2组的干预效果。 结果 826例新生儿发生医院感染52例,感染率为6.30%,其主要感染部位为呼吸道占53.85%。52例医院感染患儿共分离出病原菌58株,以革兰阴性菌(65.52%)和革兰阳性菌(31.03%)为主。单因素及多因素Logistic回归分析显示,出生体质量(OR=2.704,P=0.021)、侵入性操作(OR=5.206,P<0.001)、Apgar评分(OR=1.947,P=0.036)及抗菌药物使用时间(OR=3.126,P<0.001)是新生儿医院感染的独立危险因素。观察组的住院时间、住院费用、机械通气时间、白细胞计数、呼吸机使用率及并发症发生率均明显低于对照组(P<0.05),观察组治疗有效率明显高于对照组(P<0.05)。 结论 新生儿感染病原菌较广,医院感染的危险因素较多,集束化护理干预能提高患儿的治疗效果。 

Risk factors of neonatal nosocomial infection and effect of cluster nursing intervention

Objective To investigate the risk factors of neonatal nosocomial infection and effect of cluster nursing intervention, and to provide reference for clinical treatment. Methods A total of 826 cases of neonates were selected from Hainan maternal and child health care hospital. They were divided into hospital infection group (52 cases) and non hospital infection group (774 cases) according to the occurrence of hospital infection. Univariate and multivariate Logistic regression analysis were used to analyze the risk factors of nosocomial infection in neonates. Fifty-two cases of hospital infection were randomly divided into the control group and the observation group, with 26 cases in each group. The control group was given routine care, the observation group was treated by cluster nursing on the basis of routine care, and the intervention effect between the two groups was compared. Results There were 52 cases of nosocomial infection in 826 neonates, the infection rate was 6.30%, and the main infection site was respiratory tract, accounting for 53.85%. A total of 58 strains of pathogenic bacteria were isolated from 52 children with nosocomial infection, mainly Gram negative bacteria (65.52%) and gram positive bacteria (31.03%). Univariate and multivariate Logistic regression analysis showed that birth weight (OR=2.704, P=0.021), invasive operation (OR=5.206, P<0.001), Apgar score (OR=1.947, P=0.036) and antimicrobial use time (OR=3.126, P<0.001) were neonatal nosocomial infection independent risk factors. The hospitalization time, hospitalization expenses, mechanical ventilation time, white blood cell count, ventilator use rate and complication rate of the observation group were significantly lower than those in the control group(P<0.05). The effective rate of observation group was significantly higher than that of the control group (P<0.05). Conclusion The pathogens of neonatal infection are quite extensive, and the risk factors of nosocomial infection are varied. Cluster nursing intervention can improve the treatment effect among children.