CAJ | 학술논문

目的：探讨2010—2013年陕西省结核病防治院院内感染的变化情况，了解目前医院感染控制的一系列措施的有效性，为进一步做好结核病防治院感染的控制、管理和督查工作，预防和降低结核病患者医院感染的发生提供依据。方法采用回顾性调查，结合上报的《医院感染报告卡》，对2010—2013年间住院并发生医院感染的462例结核病患者进行临床分析。结果2010—2013年间住院的14110例患者中，有462例发生医院感染，发生率为3.27%；感染部位以下呼吸道感染为主，占69.05%；引起医院感染的病原菌以真菌为主，占48.05%，革兰阴性杆菌次之，占37.45%。结核患者的年龄、住院时间长短、有无基础疾病和是否接受侵袭性操作不同的患者，其院内感染发生率不同，差异均有统计学意义（P ＜0.05）。结论我院院内感染发生率有逐年降低的趋势，高龄患者、住院时间长的患者是院内感染的重点管理人群。缩短住院间，减少或避免侵入性操作，合理使用抗菌药物，做好重点人群、重点科室的目标监测，对控制医院感染率有重要意义。
목적：탐토2010—2013년합서성결핵병방치원원내감염적변화정황，료해목전의원감염공제적일계렬조시적유효성，위진일보주호결핵병방치원감염적공제、관리화독사공작，예방화강저결핵병환자의원감염적발생제공의거。방법채용회고성조사，결합상보적《의원감염보고잡》，대2010—2013년간주원병발생의원감염적462례결핵병환자진행림상분석。결과2010—2013년간주원적14110례환자중，유462례발생의원감염，발생솔위3.27%；감염부위이하호흡도감염위주，점69.05%；인기의원감염적병원균이진균위주，점48.05%，혁란음성간균차지，점37.45%。결핵환자적년령、주원시간장단、유무기출질병화시부접수침습성조작불동적환자，기원내감염발생솔불동，차이균유통계학의의（P ＜0.05）。결론아원원내감염발생솔유축년강저적추세，고령환자、주원시간장적환자시원내감염적중점관리인군。축단주원간，감소혹피면침입성조작，합리사용항균약물，주호중점인군、중점과실적목표감측，대공제의원감염솔유중요의의。
Objective By analyzing the changes of infection in recent years in tuborculosis prevention hospital in Shanxi Province,so as to understand the effectiveness of a series of measures in the hospital infection control in order to further provide the basis for promoting the direction,administration and surveillance of nosocomial infection control in TB hospital,and to prevent the onset of nosocomial infection and reduce its rate. Methods A prospective survey was conducted combined with the“report card”of hospital infection. 462 cases of TB patients from 2010 to 2013 were analyzed. Results Nosocomial infection happened in 462 cases-times out of 14 110 cases,and the infection rate was 3. 28% . The main infection site was lower and upper respiratory tract,accounting for 69. 05% . The nosocomial infection cases were mostly caused by pathogens and followed by Gram-negatives bacilli,accounting for 48. 05% and 37. 45% . The infection rate was associated with patients'age,hospitalization time,the underlying diseases,the use of antibiotic and anti-tuberculosis drugs,various invasive operations and immune function of patients(P < 0. 05). Conclusions The infection rate showed a decreasing trend year by year. The elderly patients and long-time hospitalization patients are the focal point management. It is important for decreasing the incidence of infection to shorten the hospitalization time,rational use of antibacterial drugs,and target monitoring on focus groups and key departments.