【摘要】 目的 :探讨儿科医院感染 (NI)的危险因素及其研究方法。方法 :采用巢式病例对照研究方法。选择 96例 NI患儿为观察组 ,又 96例患儿为对照组。两组患儿同科室 ,同性别 ,年龄相仿 (± 2岁 ) ,基础病相同及病情相仿 ,入院时间相隔 <7d。以性别、年龄、住院时间、急性生理功能和慢性健康状况评分系统 (APACHE )的分值、住院环境、各种治疗方式等 34种可能的危险因素为研究内容 ;以多元回归分析行统计学处理。结果 :NI以呼吸道感染为主 (73.8% ) ,其次为消化道(6 .8% )及泌尿道 (5 .8% )感染 ;病原体 :细菌 5 3.4 % ,病毒 2 4 .3% ,混合性 13.6 % ,真菌 8.7% ;NI风险性与 APACHE 分值、免疫系统受损、使用激素及气管插管天数等因素成正相关 (P <0 .0 5或 P <0 .0 0 1)。结论 :巢式病例对照研究能较准确地显示儿科 NI的危险因素 ,儿科 NI独立的危险因素有 APACHE 分值、免疫系统受损、使用激素及气管插管天数更多还原

【Abstract】 Objective:To investigate the risk factors of nosocomial infections ( NI ) in pediatrics and to explore the methods of investigating them Methods:The nested case control study was adopted Ninety six children with NI were selected into the observed group and 96 sick children into the control group The children in the two groups were in the same ward with the same sex, similar age (±2 years) as well as with the same disease and state of illness, and their admitted dates were < 7 days apart Thirty four possible risk factors, including sex, age, length of hospitalization, acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) scores, hospitalization environment, various treatment regimens, etc , were studied The data were statistically processed with multiple regression analysis Results: Respiratory tract infections(73 8%) were the leading NI , and digestive tract(6 8%) and genitourinary tract (5 8%) infections took second place The pathogens of NI were bacteria (53 4%), viruses(24 3%), mixed organisms(13 6%) and fungi(8 7%) The risk of NI was positively correlated with such factors as APACHEⅡ scores, impairment of immunological system, the use of hormones , the length of tracheal intubation , etc (P<0 05 or P<0 001) Conclusion:The risk factors of NI in pediatrics can be more precisely revealed through nested case control study The independent risk factors of NI are APACHE Ⅱ scores, impairment of immunological system, the use of hormones as well as the length of tracheal intubation更多还原