重症急性胰腺炎患者医院感染危险因素分析*

Risk factors of nosocomial infection in patients with severe acute pancreatitis*

摘要:

目的 分析重症急性胰腺炎（SAP）患者医院感染的发生情况及相关危险因素，以制定预防措施，减少医院感染的发生。方法 回顾性分析2011年1月—2017年12月东莞市人民医院收治的113例SAP患者的临床资料，分析医院感染发生情况及相关危险因素，采用SPSS 22.0统计软件进行分析。结果 113例SAP患者发生医院感染29例，医院感染发生率为25.66%，以下呼吸道感染为主（60.00%），检出病原菌35株，以革兰阴性杆菌为主（54.29%）。住院天数>14?d、采用机械通气、深静脉置管、留置导尿、入住重症监护病房（ICU）天数>6?d、改良CT严重指数（MCTSI）评分>6是SAP患者发生医院感染的危险因素。入住ICU天数>6?d、 MCTSI评分>6是医院感染的独立危险因素。SAP患者发生医院感染的病死率高于未发生医院感染者（P?< 0.05）。结论 SAP患者的医院感染发生率较高，ICU入住时长和MCTSI评分与医院感染的发生密切相关，应尽量缩短ICU住院时间，对MCTSI评分高的患者应加强防治措施，避免医院感染发生。

Abstract:

Objective To investigate the prevalence and risk factors of nosocomial infection in the patients with severe acute pancreatitis (SAP). Methods Totally 113 SAP patients who were admitted into our hospital during Jan. 2011 to Dec. 2017 were involved in this study. Incidence of nosocomial infection and the related risk factors of infection were recorded. Results Exactly 29 out of 113 (25.66%) patients had the nosocomial infection. Pulmonary infection accounted for major source (60.0%), and Gram-negative bacteria were the main pathogens (54.29%). The risk factors for the nosocomial infection included the length of hospital stay > 14 days, mechanical ventilation, deep vein catheterization, indwelling catheter, the length of ICU stay > 6 days, modified CT severity index (MCTSI) score > 6. The length of ICU stay > 6 days and the score of MCTSI > 6 were the independent risk factors for nosocomial infection. Mortality in SAP patients with nosocomial infection was higher than non-infected patients (P?< 0.05). Conclusions SAP patients experience increased risk of nosocomial infection, which could be manifested by prolonged length of ICU stay and greater MCTSI score.