480例烧伤科手术患者医院感染危险因素调查
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姚新宝

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R181.3+2

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新疆维吾尔自治区人民医院院内科研项目(20140126)


Risk factors for healthcareassociated infection in 480 burn patients undergoing surgery
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    摘要:

    目的了解烧伤科手术患者医院感染的危险因素,为有效降低患者医院感染发病率提供理论依据。方法采用回顾性调查的方法,对某三级甲等综合医院2015年1—12月烧伤科收治的480例手术患者进行调查,分析其发生医院感染的相关危险因素。结果480例烧伤手术患者,发生医院感染38例、44例次,医院感染发病率为7.92%,医院感染例次发病率为9.17%。感染部位以手术部位(19例,占43.18%)、血液(8例,占18.18%)和下呼吸道(5例,占11.36%)为主。单因素分析结果显示:合并糖尿病、手术时机、手术持续时间、入住重症监护病房(ICU)、住院日数、使用有创呼吸机、中心静脉置管、留置导尿管与医院感染的发生有关(均P<0.05);多因素logistic回归分析结果显示:手术持续时间≥3 h(OR=4.455,P<0.001)、住院日数>30 d(OR=4.417,P<0.001)和留置导尿管(OR=4.215,P<0.001)是烧伤科手术患者发生医院感染的危险因素。结论加强围手术期管理,缩短手术时间,避免不必要的留置导尿以及缩短患者住院日数,有助于减少烧伤科手术患者医院感染的发生。

    Abstract:

    ObjectiveTo study the risk factors for healthcareassociated infection (HAI) in burn patients undergoing surgery, and provide theoretical basis for the effective reduction of HAI in burn patients.Methods480 burn patients who underwent surgery in a tertiary firstclass comprehensive hospital from January to December 2015 were surveyed retrospectively, risk factors for HAI were analyzed.ResultsAmong 480 burn patients, 38 had 44 times of HAI, incidence and case incidence of HAI were 7.92% and 9.17% respectively. The main infection sites were surgical site (n=19, 43.18 %), bloodstream (n=8, 18.18%), and lower respiratory tract(n=5, 11.36%). Univariate analysis result showed that combined diabetes, timing of surgery, duration of surgery,stay in intensive care unit,length of hospital stay, mechanical ventilation, central venous catheterization, and urinary tract catheterization were all related with the occurrence of HAI (all P< 0.05); Multivariate logistic regression analysis showed that duration of operation≥3 hours(OR=4.455,P<0.001), length of hospital stay>30 days(OR=4.417,P<0.001), and urinary tract catheterization(OR=4.215,P<0.001) were all risk factors for HAI in burn patients undergoing surgery.ConclusionStrengthening perioperative management, shortening duration of surgery,reducing unnecessary urinary catheterization, and shortening length of hospital stay can effectively reduce the occurrence of HAI in burn patients undergoing surgery.

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张艳霞,姚新宝,热娜·吐尔逊.480例烧伤科手术患者医院感染危险因素调查[J]. 中国感染控制杂志,2016,15(12):926-929. DOI:10.3969/j. issn.1671-9638.2016.12.007.
Risk factors for healthcareassociated infection in burn patients undergoing surgery. Risk factors for healthcareassociated infection in 480 burn patients undergoing surgery[J]. Chin J Infect Control, 2016,15(12):926-929. DOI:10.3969/j. issn.1671-9638.2016.12.007.

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  • 收稿日期:2016-04-06
  • 最后修改日期:2016-06-23
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  • 在线发布日期: 2016-12-30
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