神经外科发生院内感染的相关因素Logistic回归分析(1)
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[摘要] 目的：探讨神经外科院内感染发生的相关危险因素及护理对策。方法：回归性地分析2009年1月～2011年5月在本院神经外科住院的778例患者的临床资料，采用单因素卡方检验分析感染患者和未感染患者临床资料的差异，单因素分析有意义的指标纳入多因素非条件Logistic回归分析。结果：神经外科发生院内感染率为14.01%，感染部位以下呼吸道最为常见为53.21%，其次为泌尿系感染为19.27%，其中脑出血、重度颅脑损伤、急诊入院、气管插管治疗、颅脑引流、泌尿道插管治疗、住院时间>15 d、机械通气时间>7 d是神经外科院内感染的危险因素。结论：神经外科发生院内感染情况较为严重，因此要采取相应的护理措施。
[关键词] 神经外科；院内感染；危险因素；Logistic回归分析
[中图分类号] R195 [文献标识码] C[文章编号] 1674-4721(2011)08(b)-151-03
Logistic regression analysis about the related risk factors of neurosurgical nosocomial infections
ZHANG Zuolian, ZHANG Xianqiang
The Neurosurgery Department of Heyuan People's Hospital, Guangdong Province, Heyuan 517000, China
[Abstract] Objective: To investigate the related risk factors of neurosurgical nosocomial infections and nursing measures. Methods: The clinical data of 778 patients hospitalized in our hospital from January 2009 to May 2011 were retrospectively analyzed. The difference of clinical data infected patients and uninfected patients were analyzed by using single-factor analysis of chi-square test. Meaningful indicators by Single-factor analysis were analysised by multi-factor non-conditional logistic regression analysis. Results: Neurosurgical nosocomial infection rate was 14.01%. The most common site of infection was lower respiratory tract, the rate was 53.21%, followed by urinary tract infection was 19.27%. Cerebral hemorrhage, severe traumatic brain injury, emergency admission, endotracheal intubation, brain drainage, urinary tract catheterization, length of stay >15 d, mechanical ventilation >7 d were the neurosurgical nosocomial infection risk factors. Conclusion: The neurosurgical nosocomial infection is more serious, so to take appropriate care measures.
[Key words] Neurosurgery; Nosocomial infection; Risk factors; Logistic regression analysis
院内感染(nosocomial infections，NI)的定义是指在医院获得的感染，包括在住院中和住院时，出院后2 d内发生的感染[1]。近年来医院感染的问题越来越受到人们的关注和重视，而神经外科患者具有病情重、免疫功能低下、侵入性操作多和手术创伤大等特点，发生院内感染机会多[2]，国内的研究结果显示神经外科重症监护室的院内感染率为15.76%[3]。因此认真分析研究神经外科院内感染的相关因素，并采取有力的护理预防措施，对预防和减少院内感染有着重要的临床意义，为此本研究对2009年1月～2011年5月在本院神经外科住院的778例患者进行了院内感染的相关调查，现报道如下：
1 资料与方法
1.1 一般资料
对2009年1月～2011年5月在本院神经外科住院的778例患者，年龄4～78岁，平均(52.4±32.3)岁，其中，男性423例，女性355例。
1.2 调查方法 ......
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