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目的:探讨新生儿重症监护病房(NICU)院内感染的高危因素,总结防治策略供临床参考。方法:采用回顾性研究方法,通过医院信息系统(HIS)收集2012年6月至2016年6月我院NICU发生院内感染的319例新生儿的临床资料。结果:我院NICU院内感发生率为7.00%(319/4 557)。319例发生院内感染的新生儿中,早产儿225例(70.53%),胎龄(32.54±2.31)周,出生体质量(1 825.81±635.32)g,发生院内感染的时间为入住NICU后3~36(12.56±9.00)d,病死率5.33%(17/319)。NICU院内感染与多种因素有关,其中,侵入性操作(气管插管、PICC等)、极低出生体质量、基础疾病、医源性传播是高危因素。结论:加强NICU规范管理、提高医护人员的院内感染防控意识、严格无菌操作等,能减少NICU院内感染的发生。
Objective: To investigate the high risk factors of nosocomial infection in neonatal intensive care unit (NICU) and to summarize the control strategies for clinical reference. Methods: A retrospective study was conducted to determine the clinical data of 319 newborns with nosocomial infections in NICU from June 2012 to June 2016 through the Hospital Information System (HIS). Results: The incidence of NICU in our hospital was 7.00% (319/4 557). Among 319 newborns with nosocomial infection, 225 (70.53%) were premature infants, gestational age (32.54 ± 2.31) weeks and birth weight (1825.81 ± 635.32) g. The nosocomial infection time was 3 ~ 36 (12.56 ± 9.00) d, and the case fatality rate was 5.33% (17/319). NICU nosocomial infections and a variety of factors, including invasive procedures (tracheal intubation, PICC, etc.), very low birth weight, underlying diseases, iatrogenic transmission is a risk factor. Conclusion: To strengthen NICU standard management, raise awareness of prevention and control of nosocomial infections among medical staff, and strictly enforce aseptic techniques can reduce the incidence of nosocomial infections in NICU.