皮肤去定植菌对急诊危重患者感染的预防效果研究

发布时间：2018-06-10 20:01

本文选题：定植菌 + 病原菌　；参考：《中华医院感染学杂志》2017年17期

【摘要】：目的探究皮肤去定植菌对急诊危重患者感染的预防效果。方法选择2013年1月-2016年12月医院急诊危重症患者876例,将患者随机分为对照组和研究组,其中对照组440例,研究组436例;对照组患者采用生理盐水进行常规擦浴,并对口腔进行清洁,研究组患者采用复方氯己定擦浴、醋酸氯己定溶液对口腔进行清洁,莫匹罗星对鼻腔进行清洁,同时对经口导管、尿道管及中心静脉导管用酸性氧化电位水进行消毒;对比两组患者的感染情况,分析急诊危重患者病原菌分布及构成比,对比分析两组患者血常规、体温、C-反应蛋白(CRP)、血沉(ESR)及血清降钙素原(PCT)等指标水平。结果急诊危重患者送检标本共检出563株病原菌,其中革兰阴性菌286株占50.80%,革兰阳性菌169株占30.02%;真菌108株占19.18%;对照组患者感染率为4.77%,研究组患者感染率为1.83%,两组比较差异有统计学意义(P0.05);对照组患者的白细胞计数、中性粒细胞计数、淋巴细胞计数及单核细胞数均高于研究组患者;对照组患者的体温、CRP、ESR、PCT、TNF-α、IL-6、IL-8及IL-10水平明显高于研究组患者,两组比较差异有统计学意义(P0.05)。结论皮肤去定植菌能够降低感染发生,预防危重症患者多药耐药菌感染,提高治愈率,减少住院天数。
[Abstract]:Objective to investigate the preventive effect of dermatogenic bacteria on infection in emergency critical patients. Methods from January 2013 to December 2016, 876 emergency patients were randomly divided into control group (440 cases) and control group (436 cases). The patients in study group were cleaned with compound chlorhexidine, chlorhexidine acetate solution, nasal cavity and transoral catheter. The urethral tube and central venous catheter were disinfected with acid oxidized potential water, the infection of the two groups were compared, the distribution and composition of pathogenic bacteria in the emergency critical patients were analyzed, and the blood routine examination of the two groups were compared. The levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and serum procalcitonin (PCT) were measured. Results A total of 563 strains of pathogenic bacteria were detected in emergency and critical patients. Of these, 286 were Gram-negative bacteria (50.80), 169 Gram-positive bacteria (30.02), 108 fungi (19.18), the control group (4.77) and the study group (1.833). The difference between the two groups was statistically significant (P 0.05). The counts of neutrophils, lymphocytes and monocytes were significantly higher in the control group than in the study group, and the levels of IL-8 and IL-10 in the control group were significantly higher than those in the study group (P 0.05). Conclusion dermatogenic bacteria can reduce the incidence of infection, prevent multidrug resistant bacteria infection in critically ill patients, improve the cure rate and reduce the length of hospitalization.
【作者单位】：海南医学院附属第二医院东湖院区急诊科;
【分类号】：R459.7

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