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目的探讨慢性阻塞性肺疾病(COPD)患者医院感染的危险因素及预防控制措施。方法回顾性分析医院2009年5月-2010年3月收治的552例COPD医院感染患者临床资料,对COPD医院感染患者病历资料进行统一记录、分析,将差异有统计学意义的因素纳入多因素logistic回归分析。结果 552例COPD患者发生医院感染271例,感染率49.1%;单因素分析发现,住院时间、营养状况、抗菌药物使用种类、糖皮质激素使用及泌尿道插管,差异有统计学意义(P<0.05),多因素logistic回归分析显示,住院时间>2周、使用多种抗菌药物、使用糖皮质激素及行泌尿道插管是影响COPD患者医院感染的独立危险因素。结论应根据影响COPD患者医院感染的独立危险因素,尽量缩短住院时间、合理应用抗菌药物,确保雾化吸入及留置导管无菌操作,以降低感染风险,提高患者生存质量。
Objective To explore the risk factors of nosocomial infection in patients with chronic obstructive pulmonary disease (COPD) and its prevention and control measures. Methods Retrospective analysis of clinical data of 552 patients with COPD hospital admitted from May 2009 to March 2010 in the hospital. The medical record data of patients with COPD were collected and analyzed. The factors with statistical significance were included in the multivariate logistic regression analysis. Results Among 552 COPD patients, 271 cases of nosocomial infection occurred and the infection rate was 49.1%. Univariate analysis showed that there was significant difference in length of stay, nutritional status, antibiotic use, glucocorticoid use and urinary tract intubation (P < 0.05). Multivariate logistic regression analysis showed that hospitalization for more than 2 weeks, using a variety of antimicrobial agents, glucocorticoid and urinary catheterization were independent risk factors for nosocomial infections in COPD patients. Conclusion Independent risk factors affecting nosocomial infections in COPD patients should be shortened, hospitalization time should be shortened, antimicrobial drugs should be used rationally, and aerosol inhalation and aseptic catheterization should be ensured to reduce the risk of infection and improve the quality of life of patients.