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目的:分析急性心肌梗死患者发生医院感染的危险因素,并提出预防措施,以降低医院感染发生率。方法:回顾性分析义乌市中心医院2014年1月-2015年12月间收治的600例急性心肌梗死患者的临床资料,对其发生医院感染的相关因素进行单因素和多因素Logistic回归分析。结果:69例发生医院感染,感染率为11.5%;其中下呼吸道32例,泌尿道16例,消化道9例,上呼吸道7例,皮肤及黏膜5例。单因素分析显示,感染组患者平均年龄(68.5±10.8)岁明显比未感染组(60.3±12.1)岁大,差异有统计学意义(t=6.224,P<0.001);感染组患者住院时间(27.3±10.1)天明显比未感染组(21.3±9.4)天长,差异有统计学意义(t=5.744,P<0.001);感染组患者合并高血压比例53.3%明显比未感染组39.6%高,差异有统计学意义(χ2=12.990,P<0.001);感染组患者合并糖尿病比例26.2%明显比未感染组15.0%高,差异有统计学意义(χ2=4.267,P=0.039);感染组患者心功能III级和IV级比例83.6%明显比未感染组57.9%高,差异有统计学意义(χ2=55.346,P<0.001),多因素Logistic回归分析显示,年龄、住院时间、合并糖尿病和气管插管是急性心肌梗死患者并发医院感染的独立危险因素。结论:与急性心肌梗死患者发生医院感染的相关危险因素多,临床应积极采取针对性的预防措施,从而降低感染率。
Objective: To analyze the risk factors of nosocomial infection in patients with acute myocardial infarction and to propose preventive measures to reduce the incidence of nosocomial infections. Methods: The clinical data of 600 patients with acute myocardial infarction admitted from January 2014 to December 2015 in Yiwu Central Hospital were analyzed retrospectively. One-factor and multivariate Logistic regression analysis was performed on the related factors of nosocomial infection. Results: 69 cases had nosocomial infection, the infection rate was 11.5%. There were 32 lower respiratory tract, 16 urinary tract, 9 digestive tract, 7 upper respiratory tract, 5 skin and mucous membrane. Univariate analysis showed that the average age of the infected patients (68.5 ± 10.8) years old was significantly higher than that of the uninfected (60.3 ± 12.1) years old (t = 6.224, P <0.001); the length of hospital stay 27.3 ± 10.1) days was significantly longer than that of the non-infected group (21.3 ± 9.4) (t = 5.744, P <0.001). The proportion of patients with hypertension in the infected group was significantly higher than that in the non-infected group (39.3% The difference was statistically significant (χ2 = 12.990, P <0.001). In the infection group, the proportion of patients with diabetes mellitus was significantly higher than that in the non-infected group (26.2% vs 15.0%, χ2 = 4.267, P = 0.039) Cardiac function grade III and IV 83.6% were significantly higher than non-infected 57.9%, the difference was statistically significant (χ2 = 55.346, P <0.001), multivariate Logistic regression analysis showed that age, length of stay, with diabetes and trachea Intubation is an independent risk factor for nosocomial infections in patients with acute myocardial infarction. Conclusion: There are many risk factors associated with nosocomial infection in patients with acute myocardial infarction. Clinically, we should take targeted precautionary measures to reduce the infection rate.