慢性阻塞性肺疾病急性加重期感染危险因素分析及护理对策探讨
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摘要
目的探讨慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstruction pulmonary disease,AECOPD)患者感染的危险因素,并据此提出针对性护理对策。方法回顾性分析408例AECOPD患者的临床资料,根据是否发生感染分为感染组(143例)和未感染组(265例),分析引发感染的相关危险因素。结果多因素回归分析结果显示,留置管道、使用多种抗菌药物、使用糖皮质激素、机械通气、住院时间>2周、合并基础疾病和营养不良是导致AECOPD患者发生感染的独立影响因素(P<0.05)。结论 AECOPD患者容易发生感染,且危险因素较多;临床上要加强预防,同时针对各种危险因素采取相应处理,降低感染发病率。
Objective To examine the possible risk factors that engender infection in patients in the wake of acute exacerbation of chronic obstruction pulmonary disease( AECOPD) so as to acquire scientific knowledge to inform nursing practitioners in formulating countermeasures. Methods Firstly,the clinical data of 408 patients with AECOPD were subjected to a retrospective analysis. The patients were then divided into two groups,namely,infectious group( where infection was identified; n = 143) and non-infectious group( where no cases of infection were found; n = 265). The risk factors assumed to have caused infection were then examined. Results The Results of multivariate regression analysis showed that the catheterization,use of multiple antibiotics,use of glucocorticoid,mechanical ventilation,hospitalization duration > 2 weeks,complications with underlying diseases and malnutrition were found to play the independent factors engendering infection in patients with AECOPD( P<0.05).Conclusions AECOPD patients are prone to infection and the risk factors are manifold. Countermeasures such as effective clinical prevention and factor-specific treatment should be taken so that infection rate can be effectively reduced.
Objective To examine the possible risk factors that engender infection in patients in the wake of acute exacerbation of chronic obstruction pulmonary disease( AECOPD) so as to acquire scientific knowledge to inform nursing practitioners in formulating countermeasures. Methods Firstly,the clinical data of 408 patients with AECOPD were subjected to a retrospective analysis. The patients were then divided into two groups,namely,infectious group( where infection was identified; n = 143) and non-infectious group( where no cases of infection were found; n = 265). The risk factors assumed to have caused infection were then examined. Results The Results of multivariate regression analysis showed that the catheterization,use of multiple antibiotics,use of glucocorticoid,mechanical ventilation,hospitalization duration > 2 weeks,complications with underlying diseases and malnutrition were found to play the independent factors engendering infection in patients with AECOPD( P<0.05).Conclusions AECOPD patients are prone to infection and the risk factors are manifold. Countermeasures such as effective clinical prevention and factor-specific treatment should be taken so that infection rate can be effectively reduced.
引文
[1]陈立军,李挺建.噻托溴铵联合舒利迭对慢性阻塞性肺疾病患者的疗效观察[J].健康研究,2016,36(4):461-462.
[2]Barnes PJ.Cellular and molecular mechanisms of chronic obstructive pulmonary disease[J]. Clinics in Chest Medicine,2014,35(1):71-86.
[3]杨胜兰,冯宁翰.有效干预措施对预防慢性阻塞性肺疾病患者医院感染的临床效果研究[J].中华医院感染学杂志,2014,24(14):3492-3494.
[4]赵鹃,曾雪斌,彭端亮,等.血清降钙素原诊断医院细菌感染的临床研究[J].中华医院感染学杂志,2015,25(21):4814-4816.
[5]余长智,吐尔滚·艾萨,吴燕,等.血清降钙素原预测慢性阻塞性肺疾病急性加重期患者院内感染的临床价值[J].中华危重症医学杂志:电子版,2011,4(5):9-12.
[6]朱瑞航,屠春林,胡建荣,等.慢性阻塞性肺疾病医院感染危险因素分析[J].临床肺科杂志,2008,13(5):553-554.
[7]胡建,熊娇燕,斯一夫,等.集束化治疗对重型颅脑外伤呼吸机相关性肺炎的临床研究[J].浙江创伤外科,2011,16(6):729-732.
[8]王玉宏,张成森,乔蕾,等.影响慢性阻塞性肺疾病急性加重期医院感染危险因素Logistic回归分析[J].中华临床医师杂志:电子版,2017,11(10):1786-1790.
[9]谢呈环.不同护理干预措施对预防控制医院内感染呼吸机相关性肺炎的作用[J].中西医结合心血管病电子杂志,2017,5(11):75-76.
[10]陆淑梅,蔡和群. AECOPD重症肺炎合并感染性休克患者的护理[J].医学信息,2015,28(8):154-155.
[2]Barnes PJ.Cellular and molecular mechanisms of chronic obstructive pulmonary disease[J]. Clinics in Chest Medicine,2014,35(1):71-86.
[3]杨胜兰,冯宁翰.有效干预措施对预防慢性阻塞性肺疾病患者医院感染的临床效果研究[J].中华医院感染学杂志,2014,24(14):3492-3494.
[4]赵鹃,曾雪斌,彭端亮,等.血清降钙素原诊断医院细菌感染的临床研究[J].中华医院感染学杂志,2015,25(21):4814-4816.
[5]余长智,吐尔滚·艾萨,吴燕,等.血清降钙素原预测慢性阻塞性肺疾病急性加重期患者院内感染的临床价值[J].中华危重症医学杂志:电子版,2011,4(5):9-12.
[6]朱瑞航,屠春林,胡建荣,等.慢性阻塞性肺疾病医院感染危险因素分析[J].临床肺科杂志,2008,13(5):553-554.
[7]胡建,熊娇燕,斯一夫,等.集束化治疗对重型颅脑外伤呼吸机相关性肺炎的临床研究[J].浙江创伤外科,2011,16(6):729-732.
[8]王玉宏,张成森,乔蕾,等.影响慢性阻塞性肺疾病急性加重期医院感染危险因素Logistic回归分析[J].中华临床医师杂志:电子版,2017,11(10):1786-1790.
[9]谢呈环.不同护理干预措施对预防控制医院内感染呼吸机相关性肺炎的作用[J].中西医结合心血管病电子杂志,2017,5(11):75-76.
[10]陆淑梅,蔡和群. AECOPD重症肺炎合并感染性休克患者的护理[J].医学信息,2015,28(8):154-155.