急性脑卒中患者医院感染的临床特点分析

发布时间：2018-06-02 01:02

本文选题：急性脑卒中 + 医院感染　；参考：《中华医院感染学杂志》2016年14期

【摘要】：目的探讨急性脑卒中患者医院感染的临床特点及相关危险因素,为临床控制医院感染提供依据。方法选取医院2014年6月-2015年6月收治的急性脑卒中患者340例进行研究,筛选出发生医院感染的患者,统计医院感染发生率,分析感染部位,病原菌分布及相关影响因素。结果 340例急性脑卒中患者发生医院感染58例,感染率为17.06%;其中肺部感染31例占9.12%,尿路感染13例占3.82%,消化道感染9例占2.65%,其他部位感染5例占1.47%;共分离出69株病原菌,其中革兰阴性菌47株占68.12%,革兰阳性菌7株占10.14%,真菌15株占21.74%,年龄、意识障碍、球麻痹、侵入性操作、机械通气、糖尿病、肌力3级以下、预防性应用抗菌药物及住院时间长是急性脑卒中患者发生医院感染的影响因素;多因素Logistic回归分析显示,意识障碍、机械通气、肌力3级以下、预防性应用抗菌药物及住院时间长是其发生医院感染的独立危险因素。结论急性脑卒中患者的医院感染发生率高,应加强脑血管病的一级和二级预防,减少卒中风险,积极治疗原发病,控制相关危险因素,从而减少医院感染的发生。
[Abstract]:Objective to investigate the clinical characteristics and risk factors of nosocomial infection in patients with acute stroke and to provide evidence for clinical control of nosocomial infection. Methods 340 patients with acute stroke were selected from June 2014 to June 2015. The incidence of nosocomial infection, the location of nosocomial infection, the distribution of pathogenic bacteria and the related influencing factors were analyzed. Results among 340 patients with acute stroke, 58 were nosocomial infection, and the infection rate was 17.06.The pulmonary infection was found in 31 cases, urinary tract infection in 13 cases, gastrointestinal tract infection in 9 cases and other site infection in 5 cases (1.47%), and 69 strains of pathogenic bacteria were isolated, among which 31 cases had lung infection, 13 cases had urinary tract infection, 9 cases had digestive tract infection and 5 cases had other infection. Among them, 47 Gram-negative bacteria accounted for 68.12, 7 Gram-positive bacteria accounted for 10.14, 15 fungi accounted for 21.74, age, disturbance of consciousness, bulbar paralysis, invasive operation, mechanical ventilation, diabetes mellitus, muscle strength below grade 3, Prophylactic use of antimicrobial agents and length of stay were the influencing factors of nosocomial infection in patients with acute cerebral apoplexy. Multivariate Logistic regression analysis showed that consciousness disorder, mechanical ventilation and muscle strength were below grade 3. Prophylactic use of antibiotics and length of stay were independent risk factors for nosocomial infection. Conclusion the incidence of nosocomial infection in patients with acute stroke is high. We should strengthen the primary and secondary prevention of cerebrovascular disease, reduce the risk of stroke, treat the primary disease actively and control the related risk factors so as to reduce the incidence of nosocomial infection.
【作者单位】：河南大学淮河医院神经内科;
【基金】：河南科技攻关基金资助项目(112102310090)
【分类号】：R743.33

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