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目的探讨老年骨科患者院内感染的临床特点,分析其危险因素,为有效预防与控制医院感染提供依据。方法选取2012年2月至2014年12月我院老年骨科住院患者病历资料484份为研究样本,分析骨科患者院内总感染率;并采用随机数表法分为观察组和对照组各242例,比较两组感染率及临床资料,回顾性分析院内感染危险因素。结果 484例骨科患者中22例发生院内感染,总感染率为4.5%;其中感染部位分布调查结果为手术切口9例(40.9%),泌尿道5例(22.7%),胃肠道3例(13.6%),皮肤软组织1例(4.6%),上呼吸道2例(9.1%),其他2例(9.1%);观察组院内感染率(3.3%)高于对照组(1.2%),差异具有统计学意义(P<0.05),分析临床资料发现观察组在年龄、住院天数及骨科手术期、手术方式、是否合并糖尿病、是否合并高血压、是否留置尿管等方面与对照组比较,差异有统计学意义(均P<0.05)。结论骨科老年患者易受多因素影响发生院内感染,应针对危险因素采取有效预防措施,加强护理工作和严格无菌操作,降低患者院内感染发生率。
Objective To investigate the clinical features of nosocomial infections in elderly orthopedic patients and analyze the risk factors for providing evidences for effective prevention and control of nosocomial infections. Methods 484 cases of elderly patients with orthopedics in our hospital from February 2012 to December 2014 were selected as the study samples to analyze the total nosocomial infection rate in orthopedic patients. The random number table was divided into observation group (242 cases) and control group (242 cases) The infection rate and clinical data of two groups were compared, and the risk factors of nosocomial infection were retrospectively analyzed. Results Among the 484 orthopedic patients, 22 cases had nosocomial infection with a total infection rate of 4.5%. Among them, 9 cases (40.9%) had surgical incision distribution, 5 cases (22.7%) had urinary tract infection, 3 cases had gastrointestinal tract 13.6%), 1 case (4.6%) of skin and soft tissue, 2 cases (9.1%) of upper respiratory tract, and 2 cases (9.1%) of upper respiratory tract. The infection rate in observation group was higher than that in control group Statistical analysis (P <0.05), analysis of clinical data found that the observation group in terms of age, length of stay and orthopedic surgery, surgical methods, with or without diabetes mellitus, with or without hypertension, compared with the control group, the difference was Statistical significance (all P <0.05). Conclusion Orthopedic elderly patients susceptible to multi-factor effects of nosocomial infections should take effective preventive measures for risk factors to strengthen nursing and strict aseptic practices and reduce the incidence of nosocomial infections.