【摘要】 目的分析多病种医院感染的危险因素,确定高危人群,为制定医院感染监控措施提供依据。方法采用1∶1配比病例对照研究,资料分析采用单因素分析和多因素条件Logistic逐步回归分析相结合的方法。结果与医院感染有关的独立危险因素入院时患者的病情严重程度(OR=154),老龄(60岁以上)患者或1岁内小儿(OR=324),大于或等于3个疾病诊断(OR=174),入院时存在1处或以上的脏器功能不全或衰竭(OR=411),超过1次的侵入性检查(OR=368),泌尿道插管史(OR=260),动静脉插管史(OR=506),使用化疗药物超过10d(OR=369),使用抗菌药物种类(OR=138/种),感染前住院天数(OR=0987/d),以及几种特定的基础疾病〔恶性肿瘤(OR=275),糖尿病(OR=320),肾脏疾病(OR=453),脑梗死或脑出血(OR=543)〕。除感染前住院天数外,其余变量均与医院感染的发生呈正相关。结论医院感染的发生不仅同病人的年龄和基础疾病有关,也同住院过程中的侵入性操作和化学治疗有关。为预防和控制医院感染,应在进行各种检查时严格掌握适应症,遵守无菌操作规程和消毒技术规范,合理使用抗菌药物。更多还原

【Abstract】 Objective To analyse the factors associated with HI, to identify patients at high risk of getting HI, and to bring forth some prevention and controlling measures. Methods A 1∶1 matched case-control study was adopted. After univariate analysis was conducted for determining the variables associated with HI, a stepwise multiple-regression conditional Logistic model was developed to identify the potential independent factors associated with HI. Results Conditional Logistic regression analysis showed that the following candidates were independent risk factor. They were extreme age (OR=3.24), severity of illness (OR=1.54), cancer (OR=2.75), diabetes (OR=3.20), kidney disease (OR=4.53) and cerebral hemorrhage or infarction (OR=5.43), numbers of discharge diagnosis (OR=1.74), organ insufficiency (OR=4.11), over 2 times of invasive operation manipulation(OR=3.68), urinary catheter (OR=2.60), intravenous catheter (OR=5.06), over 10 days chemotherapy (OR=3.69), number of antibiotics prescribed (OR=1.38/kind). Hospitalization days before hospital infection (OR=0.987/d) showed no association with occurrence of hospital infection. Conclusion Protecting patients with high risk of HI, keeping with the regulation of disinfections and isolation, and complying with germfree procedure in clinical practice, using antibiotics appropriately are main measures in preventing and controlling of HI.更多还原