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李雪,赵涛,吴嘉荔,李文峰,杨立山▲.严重多发伤急诊术后入住重症监护病房医院感染的特征分析[J].中国医药科学,2019,(16):20-23        基金项目:
严重多发伤急诊术后入住重症监护病房医院感染的特征分析
Analysis on characteristics of nosocomial infection in intensive care unit after emergency operations for severe multiple trauma
  
DOI:
中文关键词:  严重多发伤;急诊手术;重症监护室;医院感染
英文关键词:Severe multiple trauma;Emergency operations;Intensive care unit;Nosocomial infection
作者单位
李雪,赵涛,吴嘉荔,李文峰,杨立山▲ 宁夏医科大学总医院急诊科,宁夏银川 750004 
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中文摘要:
      [摘要] 目的 探讨严重多发伤急诊术后入住重症监护病房医院感染的特征。 方法 对我院 2016 年 11月~ 2017 年 11 月收治的 183 例严重多发伤患者的临床资料实施回顾性分析,本组患者均在接受急诊手术后在重症监护室病房监护治疗,选取同期入住重症监护室未感染的 120 例患者,对比分析两组患者观察指标情况。 结果 在本组 183 例严重多发伤患者当中,出现医院感染的患者例数为 78 例,感染发生率为42.62%。呼吸道为主要感染部位,发生率为 55.13%。其次为创口感染,发生率为 17.95%;此次检验共检出78 株病原菌,主要包括鲍曼不动杆菌,占比率为 17.95%,铜绿假单胞菌,占比率为 15.38%。按照单因素分析结果显示,导致患者出现医院感染的相关因素主要包括年龄,创伤程度,手术频次、时间,重症监护室住院时间,呼吸机使用和导管留置时间。按照多因素回归分析结果显示,导致患者出现医院感染的独立因素主要包括创伤严重程度,手术频次和时间以及重症监护室住院时间。 结论 对于严重多发伤患者来说,在进行急诊手术后重症监护室监护治疗过程中会出现医院感染,对于术后感染危险因素则应当采取相应的预防控制措施,这样可以在较大程度上降低医院感染发生率。
英文摘要:
      [Abstract] Objective To explore the characteristics of nosocomial infection in intensive care unit after emergency operations for severe multiple trauma. Methods Clinical data of 183 patients with severe multiple trauma who were admitted and treated in our hospital from November 2016 to November 2017 were retrospectively analyzed.Patients in this group were treated in the intensive care unit ward after undergoing emergency operations.120 patients who were not infected in the intensive care unit during the same period were also selected.The observation indexes of the two groups were compared and analyzed. Results Among the 183 patients with severe multiple trauma,78 patients had nosocomial infection and the infection rate was 42.62%.The respiratory tract was the main infection site,with an incidence of 55.13%.Followed by wound infection and the incidence rate was 17.95%.78 strains of pathogens were detected in this test,including Acinetobacter baumannii,accounting for 17.95% and Pseudomonas aeruginosa,accounting for 15.38%.According to the results of univariate analysis,the related factors of nosocomial infection mainly included age,trauma degree,frequency and time of operation,length of stay in ICU,using time of ventilator and catheter indwelling time.According to the results of multivariate regression analysis,the independent factors leading to nosocomial infection in patients mainly included the severity of trauma,frequency and time of operation and length of stay in ICU. Conclusion For patients with severe multiple trauma,nosocomial infection may occur during intensive care unit monitoring after emergency operations.For postoperative infection risk factors,appropriate preventive and control measures should be taken to reduce the incidence of nosocomial infections to a large extent.
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