ICU老年患者医院感染危险因素分析
Risk factors and countermeasures of nosocomial infection in elderly patients in intensive care unit(ICU)
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摘要: 目的 分析重症监护病房(ICU)老年住院患者医院感染危险因素,探讨预防和降低医院感染发生的对策。方法 对2004年1月1日-2010年12月31日入住ICU的1 152例老年患者(年龄≥60岁),采用前瞻性目标监测方法对医院感染危险因素进行综合分析,并根据病情予以分级评定。结果 老年患者医院感染发病率为38.10%(439/1 152),患有基础疾病种类越多,医院感染率及死亡率就越高;感染部位以呼吸系统感染为主,占74.02%(325/439);感染的病原菌以革兰阴性杆菌为主,占74.12%(792/1 069);发生昏迷有123例,50例发生医院感染,医院感染率为40.65%(50/123),昏迷与老年患者医院感染率相关(χ2=7.142,P<0.01);患有恶性肿瘤69例,17例发生医院感染,医院感染率为24.63%,恶性肿瘤与医院感染率相关(χ2=5.455,P<0.05);共检出病原菌1 069株,以G-杆菌为主,占74.12%(792/1 069);住院时间长、动静脉插管、呼吸机应用、泌尿道插管、昏迷、恶性肿瘤是医院感染的高危因素。结论 老年患者医院感染发生率较高,医务人员应根据医院感染的高危因素,采取有效措施控制其发生。Abstract: Objective To analyze the risk factors of nosocomial infection in elderly patients in ICU and to explore the countermeasures of hospital infection.Methods A prospective study was carried out among 1 152 elderly patients(age≥60 years) in ICU from January 2004 to December 2010.The disease conditions of the patients were classified.Results The rate of nosocomial infection in the elderly patients was 38.10%.The patients with more underlying diseases had a higher rate of hospital infection and higher mortality.The main type of infection was respiratory infection(74.02%).The infection pathogen was mainly Gram-negative bacilli (74.11%).Length of hospitalization,urinary tract intubation,ventilator,and coma were the risk factors for nosocomial infection(P< 0.05).Conclusion Elderly patients have a high incidence of infection in hospitals and positive and effective measures should be taken to control the nosocomial infection.ICU; elderly patient; nosocomial infection; risk factor
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