脑卒中手术患者肌力与医院感染相关性研究
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摘要
目的探讨脑卒中手术患者肌力与医院感染相关性,为医院感染的预防与控制提供科学依据。方法对2016年1月1日-2017年12月31日医院神经外科病房脑卒中手术患者进行目标性监测,填写《脑卒中手术患者医院感染目标性监测调查表》,收集患者人口学特征、疾病临床特点、肌力、医院感染相关信息;并采用SPSS 22.0软件及SAS 9.4软件进行统计与分析。结果共纳入脑卒中手术患者466例,发生医院感染133例,医院感染率为28.54%;随着患者肌力下降,医院感染率呈现出上升的总体趋势;其中,肌力0～Ⅱ级患者以肺部感染和多部位感染为主,肌力Ⅲ～Ⅴ级患者以肺部感染和手术部位感染为主。结论应密切关注患者肌力,采取针对性的治疗和护理措施,降低医院感染率;对于肌力0～Ⅱ级患者重点预防患者肺部感染和多部位感染;对于肌力Ⅲ～Ⅴ级患者,除采取措施预防肺部感染外,还应重点关注手术部位感染。
OBJECTIVE To explore the correlation between muscle strength and nosocomial infection in stroke patients undergoing surgery,and to provide a scientific basis for the prevention and control of nosocomial infection.METHODS The patients with stroke in the department of neurosurgery of the hospital between Jan.1,2016 and Dec.31,2017 were included.The questionnaire of nosocomial infection in patients with stroke surgery was filled in.Demographic characteristics,clinical characteristics of the disease,muscle strength grading,and nosocomial infection information were collected.SPSS and SAS software were used for statistical analysis.RESULTS A total of466 patients with stroke were included,133 patients suffered from nosocomial infection,and the nosocomial infection rate was 28.54%.With the decrease in patients' muscle strength,the nosocomial infection rate showed an increasing trend.Patients with muscle strength level of 0～Ⅱ had mainly pulmonary infection and multi-site infection,whereas patients with muscle strength level ofⅢ～Ⅴhad mainly pulmonary infection and surgical site infection.CONCLUSION We should pay close attention to the muscle strength of patients and take targeted treatment and nursing measures to reduce the nosocomial infection rate.
OBJECTIVE To explore the correlation between muscle strength and nosocomial infection in stroke patients undergoing surgery,and to provide a scientific basis for the prevention and control of nosocomial infection.METHODS The patients with stroke in the department of neurosurgery of the hospital between Jan.1,2016 and Dec.31,2017 were included.The questionnaire of nosocomial infection in patients with stroke surgery was filled in.Demographic characteristics,clinical characteristics of the disease,muscle strength grading,and nosocomial infection information were collected.SPSS and SAS software were used for statistical analysis.RESULTS A total of466 patients with stroke were included,133 patients suffered from nosocomial infection,and the nosocomial infection rate was 28.54%.With the decrease in patients' muscle strength,the nosocomial infection rate showed an increasing trend.Patients with muscle strength level of 0～Ⅱ had mainly pulmonary infection and multi-site infection,whereas patients with muscle strength level ofⅢ～Ⅴhad mainly pulmonary infection and surgical site infection.CONCLUSION We should pay close attention to the muscle strength of patients and take targeted treatment and nursing measures to reduce the nosocomial infection rate.
引文
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[2]申海涛,刘建平.长期卧床脑卒中患者并发坠积性肺炎的影响因素[J].安徽医学,2017,38(2):198-201.
[3]张玲玲,伍嫦珠,张玲燕,等.脑卒中患者院内感染及影响因素研究[J].医院管理论坛,2018,35(7):56-58,76.
[4]冯自明,祁家祥,薛文俊.医院感染对急性脑卒中近期预后的影响分析[J].中华医院感染学杂志,2014,24(16):4020-4022.
[5]沈和平,张晓玲,官俏兵,等.老年脑卒中患者医院感染的临床特征与影响因素分析[J].浙江医学,2016,38(11):836-838.
[6]Council MR.Aids to the examination of the peripheral nervous system[M].London HM Stationery Office,1976:46.
[7]中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001,81(5):314-320.
[8]Miller CM,Behrouz R.Impact of infection on stroke morbidity and outcomes[J].Curr Neurol Neurosci Rep,2016,16(9):83.
[9]Shim R,Wong CH.Ischemia,immunosuppression and infection-tackling the predicaments of post-stroke complications.[J].Int J Mol Sci,2016,17(1):E64.
[10]Wang W,Jiang B,Sun H,et al.Prevalence,incidence,and mortality of stroke in China[J].Circulation,2017,135(8):759-771.
[11]王银河,刘伟林,朱秀芬,等.老年人群脑卒中后骨质疏松的机制和治疗[J].实用老年医学,2017,31(8):718-722.
[12]马利中,董玲婉,朱靖,等.老年脑卒中患者肺部感染、深静脉血栓发生率及相关性研究[J].中华全科医学,2016,14(12):2034-2036.
[13]陶红,江枫林,朱珍,等.老年脑卒中患者医院感染病原学及危险因素分析[J].中华医院感染学杂志,2017,27(19):4409-4411,4426.
[14]毛恩强,陈影.免疫功能障碍与围手术期感染[J].中国实用外科杂志,2016,36(2):175-178.
[15]孙志宝,安庆华,郑玉明.中枢神经感染患者血脑屏障通透性与脑脊液IgG的相关性分析[J].中华医院感染学杂志,2016,26(8):1724-1726.
[16]杨阳,隋建美.神经外科术后引流管的使用[J].癫癎与神经电生理学杂志,2016,25(1):59-61.
[17]李作凌,邢亚洲,马春晓,等.长期留置脑室引流管患者颅内感染的调查[J].中华医院感染学杂志,2016,26(6):1348-1350.
[18]郑彭,黄国志,彭生辉.下肢康复机器人对改善脑卒中偏瘫患者下肢肌力及运动功能障碍的临床研究[J].中国康复医学杂志,2016,31(9):955-959.
[19]孔林.针灸联合药透治疗对于脑卒中偏瘫患者肢体肌力及BI指数的影响研究[J].陕西中医,2018,39(5):669-671.