摘要
目的分析高压氧治疗期间院内肺部感染发生的特点和危险因素,探讨预防及控制对策。方法对2007年4月-2011年4月119例次进行高压氧治疗的住院重症患者的临床资料进行回顾性分析,先以单因素分析筛选出有统计学意义的危险因素,再通过多元logistic回归分析确定医院肺部感染的危险因素。结果 119例接受高压氧治疗患者中发生肺部感染21例、32例次,感染率为17.65%、例次感染率为26.89%,无因肺部感染死亡患者;单因素分析发现肺部感染的发生与患者性别、总治疗次数、单次周转住院天数、是否合并肺外慢性基础疾病、是否为老年患者无明显相关;与气管切开状态、意识障碍、未单加压治疗相关,差异有统计学意义(P<0.05);多因素logistic回归分析结果显示,气管造口状态、非单独加压治疗、意识障碍为肺部感染的独立危险因素。结论气管切开状态、意识障碍、未实施单加压治疗是导致的高压氧治疗期间出现肺部医院感染的主要危险因素;治疗原发病、改善患者意识状况、尽量单独加压治疗等措施对于降低高压氧治疗期间患者肺部感染的发生率具有重要意义。
OBJECTIVE To explore the features and risk factors for nosocomial pulmonary mtectmns aurmg hyperbaric oxygen therapy and put forward prevention and control countermeasures. METHODS A retrospective study was performed to analyze the clinical data of 119 case-times of critically ill patients who were hospitalized for the hyperbaric oxygen therapy from Apr 2007 to Apr 2011, then the risk factors with statistical significance were screened out through the univariate analysis, then the risk factors for the nosocomial pulmonary infections were determined by the multivariate logistic regression analysis. RESULTS Of totally 119 patients who received the hyperbaric oxygen therapy, the pulmonary infections occurred in 21 cases （32 case-times） with the infection rate of 17.65% and the case-time infection rate of 26. 89%, and no case died due to the pulmonary infections. The univariate analysis indicated that the incidence of pulmonary infections was not significantly related to the gender, total frequency of treatment, hospitalization duration of single turnover, complication of chronic underlying diseases, or old age and that it was related to the state of tracheotomy, disturbance of consciousness, and without adding single pressure treatment , the difference was statistically significant （P^0.05） ~ the multivariate logistic regression analysis revealed that the tracheostoma status, non-single pressure adding treatment, and disturbance of consciousness were the independent risk factors for the pulmonary infections. CONCLUSION The tracheostoma status, disturbance of consciousness, and non-single pressure adding treatment are the main risk factors for the pulmonary infections during the hyperbaric oxygen therapy; it is of great significance for the reduction of incidence of pulmonary infections to treat the primary diseases, improve the status of consciousness, and try to perform the single pressure adding treatment.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第21期5168-5170,共3页
Chinese Journal of Nosocomiology
基金
北京市科委首都特色临床研究基金项目(2111107067311048)
关键词
肺部感染
回顾性研究
高压氧治疗
气管造口
Pulmonary infection
Retrospective study
Hyperbaric oxygen therapy
Tracheostoma
