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目的:分析肾内科患者发生医院感染的危险因素,探讨针对性预防措施,保证患者安全。方法:选取2015年1月~2016年4月在浙江省绍兴市上虞中医医院肾内科住院治疗的患者1112例,记录患者性别、年龄、病程、住院时间、侵入性操作、使用抗菌药物种类、血清白蛋白水平、基础疾病等资料,采集患者呼吸道、消化道、泌尿道、皮肤等标本进行细菌培养判断是否发生医院感染,分析发生医院感染的相关因素和独立危险因素。结果:单因素分析结果显示,患者年龄≥60岁、住院时间≥21天,侵入性操作、使用的抗菌药物≥3种、血清白蛋白<30g/L、存在基础疾病是导致医院感染的相关因素(P<0.05);多因素分析结果显示,患者年龄≥60岁、侵入性操作、使用的抗菌药物≥3种、存在基础疾病是导致医院感染的独立危险因素(P<0.05)。结论:导致肾内科患者发生医院感染的危险因素较多,应采取针对性措施控制感染发生,保证患者安全,促进患者康复。
OBJECTIVE: To analyze the risk factors of nosocomial infection in nephrology patients and to explore the specific preventive measures to ensure the safety of patients. Methods: From January 2015 to April 2016, 1112 patients were enrolled in the Department of Nephrology, Shangyu Traditional Chinese Medicine Hospital, Shaoxing City, Zhejiang Province. The patients’ gender, age, course of disease, hospital stay, invasive procedures, antibacterial drugs, Albumin levels and underlying diseases were collected. Bacterial cultures were collected from patients with respiratory tract, digestive tract, urinary tract and skin to determine whether there was nosocomial infection and to analyze the related factors and independent risk factors of nosocomial infection. Results: The results of univariate analysis showed that patients with age ≥60 years, hospitalization ≥21 days, invasive operation, ≥3 kinds of antibacterials used, serum albumin <30g / L, and underlying diseases were the related factors of nosocomial infection (P <0.05). Multivariate analysis showed that the patients were ≥60 years of age, invasive operation, the use of antimicrobial agents ≥ 3, and the existence of underlying diseases were independent risk factors for nosocomial infection (P <0.05). Conclusion: There are many risk factors of nosocomial infection in nephrology patients. It is necessary to take targeted measures to control the occurrence of nosocomial infection, ensure the safety of patients and promote the rehabilitation of patients.