本文選題：醫(yī)院感染 + 加強治療病房��； 參考：《新疆醫(yī)科大學》2007年碩士論文

【摘要】： 目的:1)了解加強治療病房(Intansive Care Uite,ICU)醫(yī)院感染(nosocomialinfection,NI)的患病率和感染部位的狀況;2)了解ICU醫(yī)院感染的病原體分布,為臨床診療提供依據(jù);3)為ICU合理使用抗生素,降低細菌耐藥性的產(chǎn)生,同時提高感染的治療水平;4)為ICU醫(yī)院感染的預(yù)防和醫(yī)護人員個人防護提供依據(jù)。方法:對ICU 2004年1月至2006年12月間2739份出我科病例進行回顧性調(diào)查,有193例病例符合醫(yī)院感染診斷標準,同時按剔出標準排出部分病例。再對這193例醫(yī)院感染病例通過查閱病史、醫(yī)院感染登記表等,填寫統(tǒng)一調(diào)查表。調(diào)查內(nèi)容主要包括性別、年齡、原發(fā)病情況、住院天數(shù)、感染日期、易感因素、侵入性操作和抗生素使用情況、醫(yī)院感染部位、致病菌及藥敏等進行回顧性分析。其中計量資料以均數(shù)±標準差表示,計數(shù)資料用多個樣本率的比較及率的兩兩比較用Scheffe法,以上所有數(shù)據(jù)應(yīng)用SPSS13.0軟件處理;檢驗水準α=0.05。結(jié)果:2004年～2006年ICU醫(yī)院感染的平均感染率17.64%;常見感染部位是呼吸道(73.91%)、血液(6.74%)、胸膜腔(6.30%)、腹腔(6.09%)、切口(3.26%)和泌尿道(2.61%)。各部位主要病原菌種類具有統(tǒng)計學差異,呼吸道、胸腹腔以細菌為主,泌尿道以真菌為主,混合感染49.22%。醫(yī)院獲得性感染的常見病原菌是銅綠假單胞菌、肺炎克雷伯菌、大腸埃希氏、金黃色葡萄球菌、醋酸鈣鮑曼復(fù)合不動桿菌和陰溝腸桿菌。抗生素存在過度使用問題,使用較頻繁的抗生素為頭孢類、左氧類和泰能等。結(jié)論:ICU內(nèi)醫(yī)院感染的患病率人居高不下,應(yīng)加強醫(yī)院感染防治,從而降低ICU醫(yī)院感染的總體水平。ICU醫(yī)院感染部位中仍以呼吸道為主,應(yīng)加強空氣的傳播的防護,醫(yī)務(wù)人員同時應(yīng)加強呼吸道的防護以減少自身醫(yī)院感染。ICU醫(yī)院感染主要病原菌因感染部位不同而不同,菌種復(fù)雜,耐藥菌株多,應(yīng)針對感染部位的區(qū)別和菌種的區(qū)別具體做好ICU醫(yī)院感染的防護,有針對性對ICU醫(yī)院感染的具體環(huán)節(jié)予以控制。掌握病原菌變化規(guī)律,為ICU合理使用抗生素作指導(dǎo),降低細菌耐藥性的產(chǎn)生,同時提高感染的治療水平。從而從各方面有效地預(yù)防和治療ICU內(nèi)獲得性感染。
[Abstract]:Objective: to understand the prevalence of nosocomial infection (NI) in intensive Care Unit (ICU) and the location of nosocomial infection. (2) to understand the distribution of pathogens of nosocomial infection in ICU so as to provide a basis for clinical diagnosis and treatment. At the same time, to improve the treatment level of infection. 4) to provide evidence for the prevention of nosocomial infection in ICU and the personal protection of medical staff. Methods: from January 2004 to December 2006, 2739 cases of our department were retrospectively investigated. 193 cases met the diagnostic criteria of nosocomial infection, and some cases were excluded according to the criteria of excision. The 193 cases of nosocomial infection were filled out the unified questionnaire by consulting the history, the registration form of nosocomial infection and so on. Sex, age, primary disease, hospitalization days, date of infection, susceptible factors, invasive operation and use of antibiotics, nosocomial infection site, pathogenic bacteria and drug sensitivity were analyzed retrospectively. The measurement data are expressed as mean 鹵standard deviation, and the counting data are compared by multiple sample rates and by Scheffe method. All the above data are processed by SPSS 13.0 software, and the test level is 偽 0.05. Results: the average nosocomial infection rate in ICU from 2004 to 2006 was 17.64.The common infection sites were respiratory tract (73.91%), blood (6.74%), pleural cavity (6.30%), abdominal cavity (6.09%), incision (3.26%) and urinary tract (2.61%). The main pathogens were mainly bacteria in respiratory tract, chest and abdomen, fungi in urinary tract, and mixed infection in 49.2222. The common pathogens of nosocomial infection are Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus, Acinetobacter and Enterobacter cloacae. The overuse of antibiotics is a problem, and the frequently used antibiotics are cephalosporins, levamoxins and Tyranone, etc. Conclusion the prevalence rate of nosocomial infection in ICU remains high and the prevention and treatment of nosocomial infection should be strengthened so as to reduce the overall level of nosocomial infection in ICU. The respiratory tract is still dominant in the nosocomial infection in ICU and the prevention of air transmission should be strengthened. At the same time, medical staff should strengthen respiratory tract protection to reduce their own nosocomial infection. The main pathogens of nosocomial infection in ICU are different because of different infection sites, complex strains and many drug-resistant strains. The prevention of nosocomial infection in ICU should be done according to the difference of infection sites and strains, and the specific links of nosocomial infection in ICU should be controlled. To master the regularity of pathogenic bacteria, to guide the rational use of antibiotics in ICU, to reduce the production of bacterial drug resistance, and to improve the treatment level of infection. In order to effectively prevent and treat acquired infection in ICU from various aspects.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2007
【分類號】：R181.3

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