妇产科住院患者院内感染发生情况及影响因素分析
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摘要
目的回顾性分析妇产科患者院内感染发生情况及相关影响因素。方法将本院在2014年5月至2016年10月期间收治的280例妇科及160例产科住院患者纳入研究,回顾性分析患者的临床资料,分别对患者院内感染发生率及发生部位、感染患者的年龄情况进行分析。根据是否感染,将患者分为感染组和未感染组,对比分析两组患者的住院时间及留置导尿管、使用呼吸机、接受动静脉插管的情况。结果 440名妇产科住院患者中,有33例发生院内感染,感染率为7.50%,其中妇科280例调查对象,发生院内感染22例,感染率为7.86%;产科160例调查对象中,发生院内感染11例,感染率为6.88%。在妇科感染患者中,有2例发生宫腔感染,而产科无宫腔感染发生;妇科患者中,感染病例在不同年龄组的分布有统计学差异(P<0.05);产科患者中,感染病例在不同年龄组的分布情况无明显差异(P>0.05);妇科和产科感染组患者的住院时间明显高于未感染组,差异有统计学意义(P<0.05);妇科感染组导尿管使用率(72.73%)、呼吸机使用率(18.18%)、动静脉插管使用率(4.55%)均明显高于未感染组(分别为18.22%、5.81%、2.71%),P<0.05。产科感染组导尿管使用率(45.45%)明显高于未感染组(23.49%),P<0.05;而呼吸机使用率和动静脉插管使用率两组无明显差异(P>0.05)。结论住院时间、留置导尿管、使用呼吸机等均为院内感染的影响因素,减少住院时间和侵入性操作的使用可有效降低妇产科患者院内感染的发生率。
Objective To retrospectively analyze the incidence of nosocomial infections in obstetrics and gynecology patients and related factors. Methods We selected 280 gynecological patients and 160 obstetric ones who had been treated in our hospital between May 2014 and October 2016. The patients' clinical data was analyzed retrospectively. The incidence of nosocomial infections in patients,the location of occurrence,the age of infected persons were analyzed respectively. These patients were divided into the infected group and the non-infected group depending on whether they were infected. The duration of hospital stay,use of the indwelling catheter and ventilator,and arteriovenous intubation were compared between the two groups. Results Among the 440 obstetric and gynecological inpatients,33( 7. 50%) developed nosocomial infections. Among the 280 cases of gynecological patients,there were 22 cases of nosocomial infections,and the infection rate was 7. 86%. Of the 160 hospitalized patients,11( 6. 88%) had nosocomial infections. Among patients with gynecological infections,there were 2 cases of uterine infection. Among gynecological patients,the distribution of infections in different age groups was significantly different( P<0. 05).In obstetric patients,there was no significant difference in the distribution of infections between different age groups( P>0. 05).The hospital stay of the gynecological and obstetric infection group was significantly longer than that of the non-infected group,the difference was statistically significant( P < 0. 05). The rate of catheterization( 72. 73%),ventilator utilization rate( 18. 18%) and arteriovenous intubation rate( 4. 55%) in the gynecological infection group were significantly higher than those in the non-infected group( 18. 22%,5. 81%,2. 71 %),P<0. 05. The rate of catheterization in the obstetric infection group( 45. 45%) was significantly higher than that in the non-infected group( 23. 49%)( P<0. 05). There was no significant difference between the two groups in the use rate of ventilators or in the rate of arteriovenous intubation( P>0. 05). Conclusion The length of hospital stay,indwelling catheters,and use of ventilators are influencing factors for nosocomial infection. Shortened hospital stay and the use of invasive procedures can effectively reduce the incidence of nosocomial infections in obstetrics and gynecology patients.
Objective To retrospectively analyze the incidence of nosocomial infections in obstetrics and gynecology patients and related factors. Methods We selected 280 gynecological patients and 160 obstetric ones who had been treated in our hospital between May 2014 and October 2016. The patients' clinical data was analyzed retrospectively. The incidence of nosocomial infections in patients,the location of occurrence,the age of infected persons were analyzed respectively. These patients were divided into the infected group and the non-infected group depending on whether they were infected. The duration of hospital stay,use of the indwelling catheter and ventilator,and arteriovenous intubation were compared between the two groups. Results Among the 440 obstetric and gynecological inpatients,33( 7. 50%) developed nosocomial infections. Among the 280 cases of gynecological patients,there were 22 cases of nosocomial infections,and the infection rate was 7. 86%. Of the 160 hospitalized patients,11( 6. 88%) had nosocomial infections. Among patients with gynecological infections,there were 2 cases of uterine infection. Among gynecological patients,the distribution of infections in different age groups was significantly different( P<0. 05).In obstetric patients,there was no significant difference in the distribution of infections between different age groups( P>0. 05).The hospital stay of the gynecological and obstetric infection group was significantly longer than that of the non-infected group,the difference was statistically significant( P < 0. 05). The rate of catheterization( 72. 73%),ventilator utilization rate( 18. 18%) and arteriovenous intubation rate( 4. 55%) in the gynecological infection group were significantly higher than those in the non-infected group( 18. 22%,5. 81%,2. 71 %),P<0. 05. The rate of catheterization in the obstetric infection group( 45. 45%) was significantly higher than that in the non-infected group( 23. 49%)( P<0. 05). There was no significant difference between the two groups in the use rate of ventilators or in the rate of arteriovenous intubation( P>0. 05). Conclusion The length of hospital stay,indwelling catheters,and use of ventilators are influencing factors for nosocomial infection. Shortened hospital stay and the use of invasive procedures can effectively reduce the incidence of nosocomial infections in obstetrics and gynecology patients.
引文
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[14]李静,张丽,张玉倩.妇科腹腔镜手术并发症原因分析[J].中国计划生育和妇产科,2017,9(9):75.
[15]王凤英,吴香竹,张菁云.妇产科患者术后感染的临床分析[J].中华医院感染学杂志,2015,27(6):44.
[2]徐伟楠,许应坤,曹珍娣.综合ICU院内感染回顾性分析[J].昆明医科大学学报,2017,28(6):40.
[3]张翔,吕晓娟,屠晔强,等.妇科肿瘤患者医院感染的相关因素分析[J].中华医院感染学杂志,2015,27(8):57.
[4]杨淑引.妇产科住院患者继发医院感染的相关因素分析[J].浙江医学,2015,39(1):61.
[5]孙敏,钱继红,朱天闻,等.NICU新生儿院内感染情况及危险因素分析[J].国际儿科学杂志,2015,44(4):124.
[6]刘亚波,白涛,庞军,等.骨科手术患者切口感染发生情况及影响因素回顾性分析[J].解放军预防医学杂志,2017,35(7):243.
[7]黄天资,袁媛,王莎莎,等.普外科老年患者术后院内感染影响因素指标体系及预警模型的建立[J].中国现代普通外科进展,2016,19(8):667.
[8]林小婷,饶晓珍,廖宝珊.孕产妇院内感染危险因素分析[J].海南医学,2015,29(16):2470.
[9]王成,胡骁骅,沈余明,等.烧伤患者术后谵妄发生情况及其相关影响因素分析[J].山东医药,2015,61(36):82.
[10]洪燕,章波儿.产科患者院内感染的高危因素调查分析[J].中国妇幼保健,2015,30(35):6327.
[11]张小燕.妇科腹腔镜手术并发症的发生情况及相关影响因素研究[J].局解手术学杂志,2015,26(3):324.
[12]叶枫,吴瑾,余燕子.宫腔镜手术后患者院内感染的相关因素分析[J].医学临床研究,2016,33(10):1955.
[13]曹艺耀,蒲珂,闫学江,等.预防性应用抗生素对分流手术术后感染率影响的回顾性分析[J].解放军预防医学杂志,2017,35(3):234.
[14]李静,张丽,张玉倩.妇科腹腔镜手术并发症原因分析[J].中国计划生育和妇产科,2017,9(9):75.
[15]王凤英,吴香竹,张菁云.妇产科患者术后感染的临床分析[J].中华医院感染学杂志,2015,27(6):44.