院内下呼吸道感染176例临床剖析.docVIP

院内下呼吸道感染176例临床剖析 　　【摘要】目的:了解医院下呼吸道感染的概况,以便加强控制。方法调查我院2008年度院内下呼吸道感染176例。结果:≥60岁老年人发生下呼吸道感染多,原发病以肿瘤、脑血管病、肺部疾病占多数,致病菌以G-杆菌为主,G+球菌感染中MRSA达56.7%。结论:医院下呼吸道感染病原菌以G-菌为主,多重耐药是已成医院感染的重要致病菌,免疫功能低下、滥用抗感染药是造成医院感染的主要因素。 　　【关键词】医院下呼吸道感染;病原菌;抗感染药 　　 　　Nosocomial Pneumonia in Clinic:Survey and Analysis 　　ZHANG Li-li LIAN Gui-zhen RUAN Mei-li et al 　　【Abstract】OBJECTIVE: To inquire into the risk factors ofpatients with nosocomial pneumoniaand search for the effective methods to prevent and control it.METHODS All the cases of the 176 patients with nosocomial pneumoniain the clinic of our hospital were analyzed. RESULTS : The risk factors of patients with nosocomial pneumoniawere the old age,several underlying diseases, not using medicine properly during the treatment and invasive operation.The most common pathogens were mainly Gram-negativebacilli,with accounted for 45.7%.and Gram positive cocci accounted for 28.7%.CONCLUSION:The effection methods to prevent and control nosocomial pneumoniaare as the follows:to improve the staffs awareness of the danger of nosocomial pneumonia,be strict to rules of hospital isolation and sterilization,and be try to reduce invasive operation .We should strengthen the cleaning of the wards and the crewshands,strengthen the monitoring of quality and pay more attention to the primary treatment。We should use the medicine properly ,especially the use of antibiotics ,immune suppressants and hormones, and pay attention to result of culture from the microbiological laboratory.We should cure the underlying disease actively and improve the stuffers immuntity function. 　　【Key words】Nosocomial infection; Pathogen; Drug resistance 　　 　　院内下呼吸道感染是常见的医院感染疾病,在我院几年院内感染监测资料,一直位居第一位。下呼吸道感染不仅延长病人住院时间,增加住院费用,甚至导致死亡。而且随者广谱抗感染药不合理使用,耐药菌株的增加已成为临床治疗棘手的问题。为预防和控制院内下呼吸道感染的发生,提高医疗质量。对我院2008年院内下呼吸道感染病历进行调查,并分析如下。 　　 　　1 资料与方法 　　 　　采用前瞻性和回顾性调查相结合的方法对我院2008年发生的院内下呼吸道感染176病例,进行登记、汇总。诊断标准以2001年1月3日中华人民共和国卫生部发布的《医院感染诊断标准》为依据。 　　 　　2 结果 　　 　　2.1 院内下呼吸道感染概况:2008年发生下呼吸道感染