CAJ | 학술논문

目的：调查分析新生儿重症监护病房（NICU ）早产儿医院感染及其相关因素，为NICU早产儿医院感染的预防和控制提供参考依据。方法回顾性分析2012年2月－2013年10月186例NICU早产儿医院感染的临床资料，对引发NICU早产儿医院感染的相关因素进行分析；采用SPSS10．0软件对数据进行统计分析。结果186例早产患儿发生医院感染28例，感染率为15．05％；医院感染时间（15．5±10．8）d；早产儿医院感染部位以呼吸道、皮肤组织、胃肠道、泌尿道为主，分别占39．29％、21．43％、14．29％、10．71％；从血液、粪便和分泌物等标本中分离出病原菌28株，其中革兰阴性菌15株占53．58％、革兰阳性菌10株占35．71％、真菌3株占10．71％；早产儿体质量、胎龄、实施侵入性操作、住院时间、抗菌药物使用时间、肾上腺糖皮质激素使用等与早产儿医院感染的发生具有相关性（P＜0．05）。结论早产儿医院感染以呼吸道感染、革兰阴性菌感染为主，低体质量、胎龄小、实施侵入性操作、住院时间长、抗菌药物使用、肾上腺糖皮质激素使用是早产儿发生医院感染的影响因素。
목적：조사분석신생인중증감호병방（NICU ）조산인의원감염급기상관인소，위NICU조산인의원감염적예방화공제제공삼고의거。방법회고성분석2012년2월－2013년10월186례NICU조산인의원감염적림상자료，대인발NICU조산인의원감염적상관인소진행분석；채용SPSS10．0연건대수거진행통계분석。결과186례조산환인발생의원감염28례，감염솔위15．05％；의원감염시간（15．5±10．8）d；조산인의원감염부위이호흡도、피부조직、위장도、비뇨도위주，분별점39．29％、21．43％、14．29％、10．71％；종혈액、분편화분비물등표본중분리출병원균28주，기중혁란음성균15주점53．58％、혁란양성균10주점35．71％、진균3주점10．71％；조산인체질량、태령、실시침입성조작、주원시간、항균약물사용시간、신상선당피질격소사용등여조산인의원감염적발생구유상관성（P＜0．05）。결론조산인의원감염이호흡도감염、혁란음성균감염위주，저체질량、태령소、실시침입성조작、주원시간장、항균약물사용、신상선당피질격소사용시조산인발생의원감염적영향인소。
OBJECTIVE To investigate the related factors for nosocomial infections in the preterm infants of neo‐natal intensive care unit (NICU) so as to provide guidance for prevention and control of the nosocomial infections in the preterm infants of NICU .METHODS The clinical data of 186 preterm infants with nosocomial infections who were treated in the NICU from Feb 2012 to Oct 2013 were retrospectively analyzed ,the related factors for the nos‐ocomial infections in the preterm infants were analyzed ,and the statistical analysis was performed with the use of SPSS10 .0 software .RESULTS The nosocomial infections occurred in 28 of 186 preterm infants ,with the infection rate of 15 .05% ;the time of the nosocomial infections was (15 .5 ± 10 .8)d .Of the preterm infants with nosocomial infections ,39 .29% had the respiratory tract infections ,21 .43% had the skin and soft tissue infections ,14 .29%had the gastrointestinal tract infections ,and 10 .71% had the urinary tract infections .A total of 28 strains of pathogens have been isolated from the blood ,stools ,and secretions specimens ,including 15 (53 .58% ) strains of gram‐negative bacteria ,10 (35 .71% ) strains of gram‐positive bacteria ,and 3 (10 .71% ) strains of fungi .The in‐cidence of the nosocomial infections in the preterm infants was associated with the body mass index ,gestational age ,invasive operation ,length of hospital stay ,time of use of antibiotics ,and use of glucocorticoids (P<0 .05) . CONCLUSION The preterm infants with respiratory tract infections are dominant among the preterm infants with nosocomial infections which are mainly caused by the gram‐negative bacteria .The influencing factors for the noso‐comial infections in the preterm infants include the low body mass index ,short gestational age ,invasive operation , long length of hospital stay ,use of antibiotics ,and use of glucocorticoids .