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目的全面收集近年国内医院外科系统医院感染文献进行数据提取与分析,以了解国内综合医院外科系统医院感染的一般性特征,为进一步建立外科系统医院感染预警数据模型提供参考。方法以医院感染、交叉感染、院内感染、预防、控制等为检索词,计算机检索CBM、CNKI、VIP、WanFang Data等数据库在2001～2009年期间发表的相关文献,主要纳入二、三级综合医院报告数据,并进行分类和Meta分析。结果共纳入64篇文献,1 990 929例住院病例。统计结果显示,该64所医院的平均医院感染率为4.46%,平均例次感染率为4.73%;内科总感染率为23.28%,外科总感染率为17.33%,但内、外科医院感染发生例次率差异无统计学意义;革兰阴性菌感染占47.71%,革兰阳性菌感染占21.31%;平均抗生素使用比例为60.59%;医院感染平均漏报率为12.42%;医院感染高发于2～5月份。结论我国现有医院外科系统医院感染现状研究大多为证据强度不高的回顾性调查和横断面调查,且报道数据分类多不全面和不一致;内、外科间的医院感染率差异无统计学意义;漏报率较高导致原始调查数据失真将影响未来预警数学模型的建立;医院感染率存在周期性变化的特点。
Objective To comprehensively collect and analyze the data of nosocomial infections in surgical systems of domestic hospitals in recent years so as to understand the general characteristics of nosocomial infections in surgical systems of general hospitals in China and provide reference for further establishment of early warning data model of nosocomial infections in surgical systems. Methods The search terms of nosocomial infections, cross-infection, nosocomial infections, prevention and control were searched by computer. The databases of CBM, CNKI, VIP and WanFang Data were searched from 2001 to 2009, and were mainly included in the second and third level general hospitals Report data and perform classification and meta-analysis. Results A total of 64 articles were included, and 1,990,929 hospitalized cases were included. The statistical results showed that the average hospital infection rate was 4.46% and the average infection rate was 4.73%. The total internal medicine infection rate was 23.28% and the total surgical infection rate was 17.33%. However, the incidence of internal and external hospital infections Gram-negative bacteria infection accounted for 47.71%, Gram-positive bacteria infection accounted for 21.31%; The average antibiotic use rate was 60.59%; The average hospital nosocomial infection rate was 12.42%; Hospital infection occurred in 2 ~ May. Conclusions Most of the current studies on the prevalence of nosocomial infections in the surgical systems of hospitals in our country are retrospective and cross-sectional surveys with low evidence intensity, and the reported data are not comprehensive and inconsistent. There is no significant difference in the nosocomial infection rates between the internal and the surgical departments. The high false negative rate leads to the distortion of the original survey data, which will affect the establishment of the mathematical model of early warning in the future. The hospital infection rate has the characteristics of periodic changes.