糖尿病并发脑梗死患者医院感染危险因素分析及对策探讨

目的探讨糖尿病并发脑梗死（DCI）患者医院感染危险因素及对策.方法对124例医院感染DCI病例和116例无医院感染DCI病例的临床数据进行回顾性分析.结果医院感染患者大灶性梗死多见,神经功能缺损严重,住院时间延长,疗效差;侵袭性操作、抗生素预防性应用、神经功能缺损程度、空腹血糖、尿白蛋白、脑梗死灶大小、血白蛋白/球蛋白、住院天数为医院感染的独立危险因素;下呼吸道（41.5%）和泌尿道（28.1%）感染最常见;肺炎克雷伯氏菌（16.7%）、铜绿假单胞菌（15.9%）、白色念珠菌（12.1%）和大肠埃希氏菌（12.1%）为主要病原菌.结论医院感染患者病情严重,预后不良;针对危险因素采取有效防治措施,对减少医院感染和改善患者生活质量具有重要作用.

Risk factors and prevention of nosocomial infection in diabetic cerebral infarction

ObjectiveTo investigate the clinical characteristics of patients,risk factors and preventive measures of nosocomial infection in diabetic cerebral infarction(DCI).MethodsThe clinical data of 124 DCI cases with nosocomial infection and 116 DCI cases without nosocomial infection were analyzed retrospectively.ResultsThe clinical characteristics of nosocomial infection in DCI patients were that large cerebral infarction and severity neurological deficits were very common.The patients always had long hospitalization days and poor prognosis.Invasive operation,antibiotic prophylaxis,severity neurological deficits,fasting plasma glucose,urinary albumin,size of cerebral infarction,albumin/globulin and hospitalization days were the risk factors for nosocomial infection in DCI.Among the patients,nosocomial lower respiratory tract infection was the highest(41.5%),the second one was urinary tract infection(28.1%).The case that both sites of infected was common(8.9%).Klebsiella pneumoniae(16.7%),Pseudomonas aeruginosa(15.9%),Candida albicans(12.1%) and Escherichia coli(12.1%) were the most frequent pathogens.ConclusionThe patient's condition of nosocomial infection in DCI is serious and has poor prognosis.Taking preventive measures according to the risk factors can reduce the infection rate.