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目的探讨标准操作规程(standard operating procedures,SOP)对新生儿监护病房(neonatal intensive care unit,NICU)医院感染的干预效果,为其临床推广实施提供依据。方法选取某三甲医院2013年1~12月间经SOP干预的NICU患儿为对象(干预组),同时以2011年1~12月未经SOP干预的NICU患儿为对照(对照组),回顾性病例调查,调查资料用SPSS 13.0软件统计分析。结果两组新生儿在胎龄、体重、手术、输液、胸穿、基础疾病、呼吸机及肺泡表面活性物质的使用等医院感染相关危险因素间的差异均无统计学意义(均有P>0.05)。干预组1 151例患儿中,25人发生医院感染,感染率为2.17%,而对照组880例患儿中,84人发生医院感染,感染率为9.54%,干预组医院感染发生率下降(2=56.96,P<0.05);对照组日医院感染率为7.2‰,干预组日医院感染率为1.8‰,两组间的差异有统计学意义(Z=6.64,P<0.05);对照组平均住院床日数为(13.19±4.98)d,干预组平均住院床日数为(11.99±3.72)d,干预后平均住院床日数下降(t=2.39,P<0.05)。结论 SOP的实施显著降低新生儿医院感染率,缩短住院时间,值得在临床上推广使用。
Objective To investigate the effect of standard operating procedures (SOP) on nosocomial infection in neonatal intensive care unit (NICU), and provide a basis for its clinical implementation. Methods NICU children with SOP intervention in a top-rank hospital from January 2013 to December 2013 were selected as the intervention group. At the same time, NICU children without control intervention (control group) from January to December in 2011 were retrospectively reviewed Sexual case investigation, survey data using SPSS 13.0 software statistical analysis. Results There was no significant difference in the risk factors of nosocomial infection such as gestational age, body weight, operation, infusion, thoracentesis, underlying diseases, use of ventilator and alveolar surfactant between the two groups (all P> 0.05 ). In the intervention group, nosocomial infection occurred in 25 out of 151 children, with an infection rate of 2.17%. In the control group, 84 out of 880 children developed nosocomial infection with a prevalence of 9.54%. The incidence of nosocomial infections in the intervention group decreased Z2 = 56.96, P <0.05). The infection rate of Japanese hospital in the control group was 7.2 ‰, and the infection rate in the intervention group was 1.8 ‰. The difference between the two groups was statistically significant (Z = 6.64, P <0.05) The mean hospital bed days were (13.19 ± 4.98) days in the intervention group, (11.99 ± 3.72) days in the intervention group, and the mean hospital bed days were decreased after the intervention (t = 2.39, P <0.05). Conclusion The implementation of SOP significantly reduces neonatal hospital infection rate and shortens the hospital stay, which is worth to be popularized in clinic.