论文部分内容阅读
目的探讨急性脑卒中患者医院感染的临床特点,分析医院感染的危险因素。方法回顾性分析2010年6月至2011年12月住院的387例急性脑卒中患者的临床资料。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、病原菌及影响因素。结果 387例急性脑卒中患者中发生医院感染63例,感染率16.28%,感染部位以下呼吸道最多,病原菌以G-菌为主。单因素分析显示,年龄≥65岁、意识障碍、球麻痹、侵入性操作、机械通气、糖尿病、肌力3级或3级以下、预防性应用抗生素及住院时间长是急性脑卒中患者医院感染率增高的影响因素(P<0.05或P<0.01)。多因素分析显示,意识障碍、球麻痹、机械通气、肌力3级或3级以下、预防性应用抗生素及住院时间长是其发生医院感染的独立危险因素(P<0.05或P<0.01)。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。
Objective To investigate the clinical characteristics of nosocomial infection in acute stroke patients and analyze the risk factors of nosocomial infection. Methods The clinical data of 387 acute stroke patients hospitalized from June 2010 to December 2011 were retrospectively analyzed. The patients with nosocomial infection were screened, the incidence of nosocomial infection was calculated, and the infected part, pathogens and influencing factors were analyzed. Results Among 387 acute stroke patients, 63 cases were nosocomial infection, the infection rate was 16.28%. Most of the respiratory tract was below the infection site. The main pathogens were G-bacteria. Univariate analysis showed that prophylactic use of antibiotics and length of hospital stay were age-65 or older, unconsciousness, ball paralysis, invasive procedures, mechanical ventilation, diabetes mellitus, muscular strength at grade 3 or below, and hospital-acquired infection rates in patients with acute stroke Increased factors (P <0.05 or P <0.01). Multivariate analysis showed that the disturbance of consciousness, ball paralysis, mechanical ventilation, muscle strength of 3 or less, prophylactic antibiotics and long hospital stay were independent risk factors of nosocomial infection (P <0.05 or P <0.01). Conclusion The incidence of nosocomial infection in patients with acute stroke is high. Primary and secondary prevention of cerebrovascular disease should be strengthened to reduce the risk of stroke. Active treatment of primary disease and control of related risk factors should be taken to reduce the incidence of nosocomial infections.