社区老年脑卒中患者院内感染剖析.docVIP

社区老年脑卒中患者院内感染剖析 　　摘 要 目的：探讨社区全科病房老年脑卒中患者院内感染特点，并提出防治措施。方法：采用回顾性调查，分析2013年1月1日―2014年12月30日确诊为院内感染的住院老年脑卒中患者62例（感染组），将同期无院内感染的老年脑卒中患者125例作为对照组，比较两组住院时间、感染前抗生素使用等情况，并对感染组患者的感染特点进行分析。结果：与未感染组相比，感染组患者年龄、住院时间、侵袭性操作、感染前抗生素使用、日常生活活动功能损害程度均高于对照组（P0.05）。感染组患者发病部位最多是下呼吸道，其次为泌尿道和皮肤软组织，致病菌最多是铜绿假单胞菌，其次是大肠埃希菌和奇异变形杆菌。结论：对于社区老年脑卒中住院患者，缩短住院时间，减少侵袭性操作，加强康复功能训练，提高日常活动能力，有利于降低医院感染。 　　关键词 脑卒中 院内感染 老年人 社区 　　中图分类号：R743.3 文献标志码：A 文章编号：1006-1533（2016）14-0022-03 　　Analysis of nosocomial infection in the elderly patients with stroke in the community 　　QIAN Liqun， HOU Yumin， XU Liping， WANG Xiaoqin 　　（Fenglin Community Health Service Center of Xuhui District， Shanghai 200030， China） 　　ABSTRACT Objective： To explore the characteristics of nosocomial infection in the elderly patients with stroke in the community general medical ward to put forward the prevention and control measures. Methods： Retrospective investigation was used to analyze 62 cases of the hospitalized elderly stroke patients diagnosed as nosocomial infection from Jan. 1， 2013 to Dec. 30， 2014 （the infection group）， and 125 cases of elderly stroke patients without nosocomial infection during the same period were taken as a control group. Results： Compared with the control group， the age， length of hospitalization， invasive operation， use of antibiotics before infection， and the degree of functional impairment of daily living activities were higher in the infection group than in the control group（P0.05）. The most infected parts were lower respiratory tract of the patients in the infection group， followed by urinary tract and skin soft tissue. The most pathogenic bacteria were Pseudomonas aeruginosa， followed by Escherichia coli and Bacillus coli. Conclusion： For the community elderly patients with stroke hospitalized， shortening hospitalization time， reducing invasive operation， strengthening the rehabilitation function training and improving the ability of daily activities are conducive to the reduction of nosocomial infec