老年高血压脑出血患者术后医院感染危险因素及预防干预研究

发布时间：2018-06-02 10:21

本文选题：老年 + 高血压脑出血　；参考：《中华医院感染学杂志》2017年19期

【摘要】：目的研究老年高血压脑出血患者术后医院感染的相关危险因素并对其相关预防措施进行分析。方法选择2013年3月-2015年9月医院收治的560例高血压脑出血患者,详细记录患者临床资料,其相关因素进行单因素和多因素logistic回归分析,并分析感染病原菌。结果 560例高血压脑出血患者术后发生医院感染72例,感染率12.86%,感染96例次,例次感染率为17.14%,而例次感染中主要以下呼吸道感染、泌尿道感染以及颅内感染为主;患者年龄偏大、存在侵入性操作、GCS评分低、未给予经验性使用抗菌药物、白细胞计数升高、合并相关基础疾病及血清中白蛋白过低是影响患者发生医院感染的独立危险因素(P0.05);96例次感染的患者共分离出病原菌112株,革兰阴性菌74株占66.07%,革兰阳性菌28株占25.00%,真菌10株占8.93%。结论依据相关危险因素在给予术后医院感染预防上一定要严格无菌操作、做好术前术后抗菌药物的使用及加强患者营养状态,对于降低老年高血压脑出血手术患者术后医院感染概率的发生有着重要作用。
[Abstract]:Objective to study the risk factors of postoperative nosocomial infection in elderly patients with hypertensive intracerebral hemorrhage. Methods from March 2013 to September 2015, 560 patients with hypertensive intracerebral hemorrhage were selected and their clinical data were recorded in detail. The related factors were analyzed by univariate and multivariate logistic regression analysis, and the pathogenic bacteria were analyzed. Results 72 cases of nosocomial infection occurred in 560 patients with hypertensive intracerebral hemorrhage, the infection rate was 12.86, 96 times, the infection rate was 17.14%. The main infection was respiratory tract infection, urinary tract infection and intracranial infection. The patients were older, had low GCS score of invasive operation, did not give empirical use of antimicrobial agents, and the white blood cell count increased. A total of 112 pathogenic bacteria were isolated from 96 patients with nosocomial infection, including 74 Gram-negative bacteria, 28 Gram-positive bacteria and 8.93 fungi. Conclusion according to the related risk factors, the prevention of postoperative nosocomial infection must be strictly aseptic, the use of antibiotics before and after operation should be done well and the nutritional status of patients should be strengthened. It plays an important role in reducing the probability of postoperative nosocomial infection in elderly patients with hypertensive intracerebral hemorrhage.
【作者单位】：中山大学附属第五医院神经外科;
【分类号】：R651.12

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