重症监护室行体外膜肺氧合辅助治疗患者医院感染危险因素分析
Analysis of risk factors for nosocomial infection in patients undergoing auxiliary extracorporeal membrane oxygenation therapy in the intensive care unit
钟美兴 1肖金梅 1侯良 1刘子由 1王凤珍 1陈舒梅 1陈辉1
作者信息
- 1. 赣南医科大学第一附属医院,江西 赣州 341000
- 折叠
摘要
目的:了解重症监护室(Intensive care unit,ICU)行体外膜肺氧合(Extracorporeal membrane oxygenation,ECMO)辅助治疗患者医院感染情况,并分析相关危险因素.方法:收集2019年1月—2023年12月入住赣南医科大学第一附属医院ICU行ECMO辅助治疗84例患者的病历资料,将发生医院感染的42例患者设为感染组,未发生医院感染的42例患者设为未感染组,采用单因素分析及条件多因素Logistic回归分析患者发生医院感染的相关危险因素.结果:感染组共发生50例次医院感染,其中肺部感染32例次、切口感染7例次、尿路感染5例次、血流感染4例次、皮肤软组织感染2例次.致病菌以鲍曼不动杆菌、洋葱伯克霍尔德菌、肺炎克雷伯菌为主.感染组患者手术治疗率、有创呼吸时长、ECMO使用时长高于未感染组,差异有统计学意义(P＜0.05),条件多因素Logistic分析发现手术治疗、有创呼吸时长是ECMO辅助治疗患者发生医院感染独立危险因素(P＜0.05).结论:手术治疗、有创呼吸时长为ECMO辅助治疗患者医院感染发病率独立危险因素,严格围手术期医院感染防控、减少有创呼吸时长将有效降低ECMO辅助治疗患者医院感染发生率.
Abstract
Objective:To investigate the situation of nosocomial infections in patients undergoing extracorporeal mem-brane oxygenation(ECMO)auxiliary treatment in the intensive care unit and analyze related risk factors.Methods:The medical records of 84 patients admitted to the intensive care unit of The First Affiliated Hospital of Gannan Medical University for ECMO auxiliary treatment from January 2019 to December 2023 were collected.Altogether 42 patients who had nosocomial infection were include in the infection group,and another 42 patients who did not have nosocomial infection were included in non-infection group.A single-factor analysis and multi-factor logistic were used to analyze the risk factors related to nosocomial infection in the patients.Results:A total of 50 cases of hospital-acquired infections occurred in the infection group,including 32 cases of pulmonary infection,7 cases of incision infection,5 cases of urinary tract infection,4 cases of bloodstream infection,and 2 cases of skin and soft tissue infection.The main pathogenic bacteria were Acinetobacter baumannii,Burkholderia cepacia,and Klebsiella pneumoniae.The infection group had a higher rate of surgical treatment,longer duration of invasive ventilation,and longer ECMO use duration than the non-infection group,with statistically significant differences(P＜0.05).Multivariate Logistic regression analysis revealed that surgical treatment and duration of invasive ventilation were independent risk factors for hospital-acquired infections in ECMO-assisted treatment patients(P＜0.05).Conclusion:Surgical treatment and duration of invasive ventilation are independent risk factors for the incidence of hospital-acquired infections in ECMO-assisted treatment patients.Strict perioperative hospital infection control and reduction of invasive ventilation duration will effectively reduce the incidence of hospital-acquired infections in ECMO-assisted treatment patients.
关键词
体外膜肺氧合/感染/精准感控/危险因素/疾病负担Key words
Extracorporeal membrane oxygenation/Infection/Precise infectioncontrol/Risk factors/Disease burden引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据