急性脑卒中患者医院感染分析

目的为探明急性脑卒中患者医院感染的特点及危险因素,以便采取有效控制措施。方法对温州医学院附属第一医院1997年1月1日～2002年12月31日6年间收治的4730例急性脑卒中患者进行监测。结果医院感染率为1252%。女性高于男性(P<005),感染率随年龄增大而升高(P<001)。医院感染多发生在入院2周内,感染部位以呼吸道为主(4796%),其次为泌尿道(3481%)。病原菌以G-菌为主(4309%),其次为G+菌(3091%)和真菌(2600%)。耐药菌株不断增加。结论免疫功能低下、侵袭性操作、滥用抗生素和激素是急性脑卒中患者医院感染的主要危险因素。加强对细菌耐药性的监测,合理选用抗生素,是减少或延缓耐药菌株产生的关键措施。

Analysis on nosocomial infection in patients of acute stroke

Objective To explore the features and risk factors of nosocomial infection in patients of acute stroke,so as to adopt effective control measure.Method 4 730 hospitalized patients with acute stroke were monitored in our hospital from Jan.1 1997 to Dec.31 2002.Results The incidence of nosocomial infection was 12.52% and female had higher incidence than male(P<0.05).The incidence rosed while aging(P<0.01).The nosocomial infection often occurred in two weeks after hospitalization.The nosocomial respiratory tract infection was the highest risk factor(47.96%),the second was the urinary tract infection(34.8%).The most common bacteria was gram-negative bacteria(43.09%),the second was gram-positive bacteria(30.91%),the third was fungus (26.00%).Drug-resistant strains had increased.ConclusionsThe main risk factors of nosocomial infection of acute stroke included low immunological function,invasive operations,antibiotic and hormone abuse.So there was urgent need for surveillance of bacterial resistance and reasonable use of antibiotic to reduce or postpone the development of drug-resistant strains.