胸部肿瘤手术患者医院感染危险因素

Risk factors of healthcareassociated infection in thoracic tumor surgery patients

摘要:

目的探讨胸部肿瘤手术患者医院感染的危险因素。方法对某院胸外科2008年12月—2012年11月收治的796例胸部肿瘤手术患者的临床资料进行回顾性分析。结果796例胸部肿瘤手术患者发生医院感染156例，167例次，医院感染率为19.60%，例次感染率为20.98%；感染部位以下呼吸道最常见（59.28%，99/167），其次为上呼吸道（15.57%，26/167）、手术切口（10.18%，17/167）和泌尿道（5.39%，9/167）等。单因素分析结果显示，年龄≥60岁、吸烟、住院时间≥15 d、手术持续时间≥3 h、气管导管留置时间≥5 h、合并基础疾病（糖尿病、慢性支气管炎、肺功能障碍等）、术前行放（化）疗、应用中心（或外周）静脉置管、使用免疫抑制剂是患者发生医院感染的危险因素（均P＜0.05）。结论胸部肿瘤手术患者医院感染发生率高，应针对医院感染的危险因素积极采取有效预防措施，控制其发生。

Abstract:

ObjectiveTo evaluate the risk factors of healthcareassociated infection(HAI) in thoracic tumor surgery patients.MethodsClinical data of 796 thoracic tumor patients in a hospital from December 2008 to November 2012 were analyzed retrospectively.ResultsOf 796 patients, 156 developed 167 times of HAI,HAI rate was 19.60%, case infection rate was 20.98%;the most common infection site was lower respiratory tract（59.28%，99/167），followed by upper respiratory tract (15.57%，26/167）,surgical incision （10.18%，17/167）and urinary tract （5.39%，9/167）. Univariate analysis revealed that patients≥ 60 years of age, smoking, length of hospital stay ≥15 days, duration of surgery≥3 hours, tracheal catheter indwelling≥5 hours, complicated underlying diseases (diabetes,chronic bronchitis, pulmonary dysfunction,et al), preoperative radiotherapy and chemotherapy, central or peripheral venous catheterization, and use of immunosuppressive agents were risk factors for HAI in thoracic tumor surgery patients (all P<0.05). ConclusionIncidence of HAI in thoracic tumor surgery patients is high, effective preventive measures should be taken to control and reduce the occurrence of HAI.