CAJ | 학술논문

目的：探讨医院感染的危险因素，为医院感染的预防控制工作提供参考依据。方法应用流行病学调查方法收集2012年1月－2013年1月900例临床病例作为研究对象，对医院感染患者的感染相关因素进行单因素及多因素分析，采用SPSS13．0软件对数据进行统计分析。结果900例患者中有78例发生医院感染，感染率为8．67％；IC U、泌尿外科、呼吸内科、普外科等科室的感染率较高；感染部位以呼吸系统和泌尿系统为主；单因素分析显示，年龄≥60岁、有意识障碍、应用机械通气、住院时间≥10 d、有侵入性操作和联合应用抗菌药物与医院感染的发生具有相关性（P＜0．05），进一步行 logistic多元回归分析显示，年龄（OR＝1．049）、意识障碍（OR＝2．798）、机械通气（OR＝2．074）、住院时间（OR＝1．719）、侵入性操作（OR＝4．218）和联合应用抗菌药物（OR＝1．842）均与医院感染的发生呈正相关关系。结论年龄、意识障碍、机械通气、住院时间、侵入性操作和联合应用抗菌药物等均是医院感染发生的危险因素，实施规范化管理、增加相关经费投入、提高人员预防控制意识，特别是充分发挥护理管理在预防控制工作中的作用，是降低医院感染率的有效手段。
목적：탐토의원감염적위험인소，위의원감염적예방공제공작제공삼고의거。방법응용류행병학조사방법수집2012년1월－2013년1월900례림상병례작위연구대상，대의원감염환자적감염상관인소진행단인소급다인소분석，채용SPSS13．0연건대수거진행통계분석。결과900례환자중유78례발생의원감염，감염솔위8．67％；IC U、비뇨외과、호흡내과、보외과등과실적감염솔교고；감염부위이호흡계통화비뇨계통위주；단인소분석현시，년령≥60세、유의식장애、응용궤계통기、주원시간≥10 d、유침입성조작화연합응용항균약물여의원감염적발생구유상관성（P＜0．05），진일보행 logistic다원회귀분석현시，년령（OR＝1．049）、의식장애（OR＝2．798）、궤계통기（OR＝2．074）、주원시간（OR＝1．719）、침입성조작（OR＝4．218）화연합응용항균약물（OR＝1．842）균여의원감염적발생정정상관관계。결론년령、의식장애、궤계통기、주원시간、침입성조작화연합응용항균약물등균시의원감염발생적위험인소，실시규범화관리、증가상관경비투입、제고인원예방공제의식，특별시충분발휘호리관리재예방공제공작중적작용，시강저의원감염솔적유효수단。
OBJECTIVE To explore the risk factors for nosocomial infections so as to provide guidance for preven‐tion and control of the nosocomial infections .METHODS By means of epidemiological survey ,totally 900 clinical cases who were treated in the hospital from Jan 2012 to Jan 2013 were recruited as the study objects ,then the uni‐variate analysis and multivariate analysis were performed to observe the related factors for the nosocomial infec‐tions ,and the statistical analysis was carried out by using SPSS13 .0 software .RESULTS The nosocomial infections occurred in 78 of 900 patients ,with the infection rate of 8 .67% .The infections were highly prevalent in the ICU , urology department ,respiratory medicine department ,and general surgery department .The respiratory system and urinary system were the major infection sites .The univariate analysis indicated that the incidence of nosocomial infections was associated with no less than 60 years of age ,disturbance of consciousness ,mechanical ventilation , length of hospital stay no less than 10 days ,invasive operation ,and combined use of antibiotics (P<0 .05) .The multivariate logistic regression analysis further revealed that the incidence of nosocomial infections was positively correlated with the age (OR=1 .049) ,disturbance of consciousness (OR=2 .798) ,mechanical ventilation (OR=2 .074) ,length of hospital stay (OR=1 .719) ,invasive operation (OR=4 .218) ,and combined use of antibiotics (OR=1 .842) .CONCLUSION The risk factors for the nosocomial infections include the age ,disturbance of con‐sciousness ,mechanical ventilation ,length of hospital stay ,invasive operation ,and combined use of antibiotics .It is an effective way to implement standardized management ,increase related fund investment ,and give full play to the nursing management so as to reduce the incidence of nosocomial infections .