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目的:分析神经外科患者多重耐药菌感染的危险因素,为临床治疗及护理提供控制多重耐药菌措施参考。方法:采用回顾性分析方法、单因素分析和多因素回归分析法,分析2016年1月—2016年12月间收治的神经外科1 870例住院患者多重耐药菌感染的危险因素和防治对策,其中发生多重耐药菌感染的40例作为病例组,选取其中80例非多重耐药菌感染患者作为对照组,分析其发生原因。结果:经单因素分析结果显示,患者性别、年龄和是否入住ICU、机械通气、泌尿道插管、中心静脉插管、手术以及是否使用抗菌药物治疗均是多重耐药菌感染的危险因素;经多因素Logistic回归分析结果显示,患者是否入住ICU、机械通气、泌尿道插管、中心静脉插管以及是否使用抗菌药物治疗均是神经外科患者多重耐药菌感染的独立危险因素。结论:在ICU行侵入性操作是患者多重耐药菌感染的独立危险因素,应重点关注ICU中的此类患者,严格按照多重耐药菌隔离防控措施进行临床诊疗及护理操作。
OBJECTIVE: To analyze the risk factors of multiple drug-resistant bacterial infections in neurosurgical patients and provide references for the control of multiple drug-resistant bacteria in clinical treatment and nursing. Methods: The retrospective analysis method, univariate analysis and multivariate regression analysis were used to analyze the risk factors and prevention and cure strategies of 1,870 hospitalized patients with multi-drug resistant bacteria in neurosurgery from January 2016 to December 2016, Forty cases with multiple drug-resistant bacterial infections were selected as the case group. Eighty non-multi-drug resistant bacterial infections were selected as the control group, and their causes were analyzed. Results: The results of univariate analysis showed that gender, age and admission to ICU, mechanical ventilation, urinary catheterization, central venous catheterization, surgery and the use of antimicrobial agents were all risk factors for multidrug resistance infection. Multivariate Logistic regression analysis showed that whether patients were admitted to the ICU, mechanical ventilation, urinary catheterization, central venous catheterization and antimicrobial therapy were all independent risk factors for multi-drug resistant infections in neurosurgical patients. CONCLUSIONS: The invasive procedure in ICU is an independent risk factor for multi-drug resistant infections in patients. ICU should focus on such patients and strictly follow the multi-resistant isolation and control measures for clinical diagnosis and treatment and nursing.