中华医院感染学杂志
中華醫院感染學雜誌
중화의원감염학잡지
Chinese Journal of Nosocomiology
2015年
10期
2312-2313,2316
,共3页
裴俊烽%张前进%陈柏庆%金冬春
裴俊烽%張前進%陳柏慶%金鼕春
배준봉%장전진%진백경%금동춘
医院感染%消化道%恶性肿瘤%危险因素%干预
醫院感染%消化道%噁性腫瘤%危險因素%榦預
의원감염%소화도%악성종류%위험인소%간예
Nosocomial infection%Gastrointestinal tract%Malignant cancer%Risk factor%Intervention
目的：对恶性消化道肿瘤手术患者医院感染危险因素进行分析，为控制恶性消化道肿瘤手术患者医院感染发生提供理论依据。方法回顾性分析2000年5月－2013年9月接受手术治疗的980例恶性消化道肿瘤患者的病历资料，分析医院感染发生情况及危险因素，并据此提出相应的有效干预措施。结果980例患者中共有76例发生医院感染，发生率为7．8％；共分离出病原菌82株，其中革兰阳性菌34株占41．5％，革兰阴性菌32株占39．0％，真菌16株占19．5％；单因素分析结果显示，高龄、病情严重程度（GCS ）评分、免疫功能、用药天数及住院天数与医院感染的发生具有相关性（P＜0．05），进一步行多因素回归分析，结果显示，高龄、GCS评分≥7分、免疫功能低下和住院天数是医院感染发生的独立危险因素。结论恶性消化道肿瘤患者发生医院感染的风险与高龄、GCS评分≥7分、免疫功能低下及住院天数等因素具有相关性；医院应该提升管理质量，采取综合性措施控制医院感染的发生，保障患者生命安全。
目的：對噁性消化道腫瘤手術患者醫院感染危險因素進行分析，為控製噁性消化道腫瘤手術患者醫院感染髮生提供理論依據。方法迴顧性分析2000年5月－2013年9月接受手術治療的980例噁性消化道腫瘤患者的病歷資料，分析醫院感染髮生情況及危險因素，併據此提齣相應的有效榦預措施。結果980例患者中共有76例髮生醫院感染，髮生率為7．8％；共分離齣病原菌82株，其中革蘭暘性菌34株佔41．5％，革蘭陰性菌32株佔39．0％，真菌16株佔19．5％；單因素分析結果顯示，高齡、病情嚴重程度（GCS ）評分、免疫功能、用藥天數及住院天數與醫院感染的髮生具有相關性（P＜0．05），進一步行多因素迴歸分析，結果顯示，高齡、GCS評分≥7分、免疫功能低下和住院天數是醫院感染髮生的獨立危險因素。結論噁性消化道腫瘤患者髮生醫院感染的風險與高齡、GCS評分≥7分、免疫功能低下及住院天數等因素具有相關性；醫院應該提升管理質量，採取綜閤性措施控製醫院感染的髮生，保障患者生命安全。
목적：대악성소화도종류수술환자의원감염위험인소진행분석，위공제악성소화도종류수술환자의원감염발생제공이론의거。방법회고성분석2000년5월－2013년9월접수수술치료적980례악성소화도종류환자적병력자료，분석의원감염발생정황급위험인소，병거차제출상응적유효간예조시。결과980례환자중공유76례발생의원감염，발생솔위7．8％；공분리출병원균82주，기중혁란양성균34주점41．5％，혁란음성균32주점39．0％，진균16주점19．5％；단인소분석결과현시，고령、병정엄중정도（GCS ）평분、면역공능、용약천수급주원천수여의원감염적발생구유상관성（P＜0．05），진일보행다인소회귀분석，결과현시，고령、GCS평분≥7분、면역공능저하화주원천수시의원감염발생적독립위험인소。결론악성소화도종류환자발생의원감염적풍험여고령、GCS평분≥7분、면역공능저하급주원천수등인소구유상관성；의원응해제승관리질량，채취종합성조시공제의원감염적발생，보장환자생명안전。
OBJECTIVE To analyze the risk factors for nosocomial infections in the malignant gastrointestinal cancer patients undergoing surgical procedures so as to provide theoretical basis for control of the nosocomial infections in the malignant gastrointestinal cancer patients .METHODS The medical records of 980 malignant gastrointestinal cancer patients who received surgical procedures from May 2000 to Sep 2013 were retrospectively analyzed ,then the incidence of nosocomial infections and risk factors were analyzed ,and the effective interventions were put for‐ward .RESULTS The nosocomial infections occurred in 76 of 980 patients ,with the incidence rate of 7 .8% .A total of 82 strains of pathogens have been isolated , including 34 (41 .5% ) strains of gram‐positive bacteria , 32 (39 .0% ) strains of gram‐negative bacteria ,and 16 (19 .5% ) strains of fungi .The univariate analysis indicated that the incidence of nosocomial infections was associated with the advanced age ,disease severity score ,immune function ,medication duration ,and length of hospital stay (P<0 .05);the multivariate regression analysis further showed that the advanced age ,GCS score no less than 7 points ,low immune function ,and length of hospital stay were the independent risk factors for the nosocomial infections .CONCLUSION The incidence of nosocomial infec‐tions is associated with the advanced age ,GCS score no less than 7 points ,low immune function ,and length of hospital stay .It is necessary for the hospital to improve the management quality and take comprehensive control measures so as to ensure the safety of life of the patients .
