儿童神经外科手术患者医院感染危险因素分析

发布时间：2018-04-09 13:40

本文选题：儿童　切入点：脑外科　出处：《中国消毒学杂志》2017年11期

【摘要】：目的了解儿童专科医院神经外科患者医院感染的发生特点及相关危险因素,为预防术后感染提供理论依据。方法采取前瞻性目标监测,对2014年7月1日-2015年6月30日期间某儿童医院脑外科282例手术患者进行跟踪调查,分析手术患者发生医院感染的主要危险因素。结果 282例手术患者中发生医院感染28例,感染率为9.93%;医院感染29例次,例次感染率为10.28%。感染部位以上呼吸道感染为主(34.48%),其次是手术部位感染(31.03%)和下呼吸道(24.14%)。共监测脑外科手术310台,手术部位感染率为2.90%。儿童神经外科手术患者发生医院感染相关危险因素包括接受手术次数、手术时间、是否植入OMMAYAR囊、术中是否使用显微镜、术中输血史、术中留置导尿、术前预防性用药种类、术后抗生素使用天数和住院天数共9项因素;其中术中留置导尿、术后抗生素使用7 d和住院天数是主要危险因素(OR=3.53、3.40、1.02,P0.05)。结论为防控儿童医院神经外科手术患儿术后发生医院感染,重点要关注术中导尿管留置、术后抗生素使用天数和住院时间等重要危险因素,采取综合性预防措施。
[Abstract]:Objective to understand the characteristics of children's hospitals and related risk factors of hospital infection in Department of neurosurgery patients, to provide a theoretical basis for the prevention of postoperative infection. Methods a prospective target monitoring and tracking survey during the July 1, 2014 -2015 year in June 30th in a children's Hospital Department of cerebral surgery 282 cases of surgical patients, analyze the major risk factors of hospital infection occurred in surgical patients. Results 282 patients were in hospital infection in 28 cases, the infection rate was 9.93%; the hospital infection in 29 cases, cases of infection rate of 10.28%. infection in upper respiratory tract infection (34.48%), followed by surgical site infection (31.03%) and the lower respiratory tract (24.14%). A total of 310 sets of monitoring department of cerebral surgery surgery, surgical site infection rate for children with 2.90%. in Department of Neurosurgery surgery hospital infection risk factors including the frequency of operation, operation time, whether the implantation of OMMAYAR cyst operation Whether using a microscope, history of blood transfusion during surgery, intraoperative catheterization, preoperative prophylactic medication type, postoperative use of antibiotics and hospitalization time were 9 factors; the intraoperative catheterization, postoperative use of antibiotics and hospitalization of 7 d were the main risk factors (OR= 3.53,3.40,1.02, P0.05). Conclusion for the prevention and control of children the hospital department of Neurosurgery surgery with postoperative hospital infection, to be the focus of the guided indwelling catheter, postoperative antibiotic use days and hospitalization time and other important risk factors, take comprehensive preventive measures.

【作者单位】：苏州大学附属儿童医院;
【分类号】：R197.323;R726.5

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