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目的:分析心血管内科住院病人医院感染的临床特征,并提出相应解决对策。方法:收集浙江省庆元县中医院心血管内科于2010年6月~2014年6月1539名患者中的住院感染病例,共153例,占心内科住院患者9.9%,分析医院感染的临床特征和危险因素,实施风险管理,降低医院感染的发生率。结果:心功能差、并发症多、采用侵入性操作、住院时间较长为感染的主要危险因素(P<0.05)。心内科发生医院感染153例,感染率9.9%;感染部位以呼吸系统感染为主,共63例,占41.18%;其他依次为消化系统45例,占29.41%;泌尿系统23例,占15.03%;皮肤及软组织感染16例,占10.46%;其他6例,占3.92%。引起感染的菌种依次为革兰阴性菌,占60.13%;革兰阳性菌30.07%,真菌为9.80%。结论:心血管内科许多老年患者因免疫力低下、自理能力较差或丧失,同时可能合并各种疾病,且病程长,病情复杂,摄入不足,营养不良等导致医院感染的概率增大。提出预防医院感染的方法为:健全医院感染组织机构;加强医院感染控制管理;加强医护人员操作规范化,定期培训考核心血管科医护人员相关操作技能;定期对病房进行严格消毒,保持好医院环境卫生,保证病房内的空气质量;加强卧床患者的日常护理工作,尽可能降低住院、卧床时间。
Objective: To analyze the clinical characteristics of nosocomial inpatients with cardiovascular diseases and to propose corresponding solutions. Methods: A total of 153 inpatients were enrolled in the 1539 patients from June 2010 to June 2014 in Department of Cardiology, Qingyuan Hospital of Traditional Chinese Medicine, Zhejiang Province, accounting for 9.9% of hospitalized patients in cardiology department. The clinical features of nosocomial infections were analyzed And risk factors, implement risk management and reduce the incidence of nosocomial infections. Results: The main risk factors for infection were poor cardiac function, more complications, invasive operation and longer hospital stay. (P <0.05). There were 153 cases of nosocomial infection in the department of cardiology, with an infection rate of 9.9%. Infection sites were mainly respiratory infections, with a total of 63 cases (41.18%), followed by 45 cases of digestive system (29.41%), urinary system (15.03% 16 cases were infected with skin and soft tissue, accounting for 10.46%; the others were 6 cases, accounting for 3.92%. Gram-negative bacteria in turn were infected, accounting for 60.13%; Gram-positive bacteria 30.07%, fungi 9.80%. CONCLUSIONS: Many elderly patients with cardio-vascular diseases have poor or no immunity due to their poor immunity or ability to take care of themselves. At the same time, they may merge with various diseases and may increase the probability of nosocomial infection due to their long duration, complicated illness, inadequate intake and malnutrition. The methods to prevent nosocomial infection are as follows: to improve the organization of nosocomial infection; to strengthen the management and control of nosocomial infection; to strengthen the standardization of operation of medical personnel; to regularly train and evaluate the relevant operation skills of cardiologists; to regularly sterilize the wards and maintain good hospital environmental hygiene , To ensure that the air quality within the ward; to enhance the routine care of bedridden patients, as much as possible to reduce hospitalization, bed time.