本刊首页 > 期刊目次 > 老年精神疾病患者医院感染相关因素筛查及预防对策研究

• 文章 •

老年精神疾病患者医院感染相关因素筛查及预防对策研究

  • 张月芳

* 通信作者: 张月芳, 单位:河南省洛阳荣康医院健康管理体检中心,河南洛阳, 471000

摘要

【摘要】
目的 研究老年精神病患者医院感染相关因素及预防对策。

方法 选取2017年1月至2018年6月医院老年精神病患者334例,重点监测医院感染患者,建立多因素Logistic回归模型归纳与总结老年精神病患者医院感染相关危险因素,有
目的性的制定预防对策。

结果 医院感染31例、感染率9.28%。临床单因素中的年龄(≥70岁)、具有2型糖尿病史、慢性阻塞性肺疾病史、精神病种类(精神分裂症、阿尔兹海默症)、皮肤或粘膜缺损、使用抗精神病药物(>2种)、侵入性操作(>2次)、未行保护性约束、贫血、未预防使用抗菌药物、抗菌药物使用时间(≥14d)、住院时间(≥28d)、病房环境(一般)的老年精神病患者医院感染率高于年龄(<70岁)、无2型糖尿病史、慢性阻塞性肺疾病史、精神病种类(老年抑郁症、脑损伤伴发精神障碍)、皮肤或粘膜无缺损、使用抗精神病药物(≤2种)、侵入性操作(≤2次)、行保护性约束、无贫血、预防使用抗菌药物、抗菌药物使用时间(<14d)、住院时间(<28d)、病房环境(良好)的老年精神病患者医院感染率,差异有统计学意义(P<0.05)。且老年精神病医院感染患者Th1、Th2、Th17百分率高于未感染患者,CD4+、CD8+百分率低于未感染患者,CD4+/CD8+比值高于未感染患者,FEV1/FVC百分率低于未感染患者,差异有统计学意义(P<0.05)。建立多因素Logistic回归模型,筛查出2型糖尿病史、慢性阻塞性肺疾病史、精神病种类、皮肤或粘膜缺损、使用抗精神病药物、侵入性操作、贫血、抗菌药物使用时间、CD4+T细胞亚群是老年精神病患者医院感染高危风险因素,保护性约束、预防使用抗菌药物、病房环境、T淋巴细胞亚群、肺功能是老年精神病患者医院感染保护性因素。

结论 老年精神病患者医院感染相关因素复杂多样,加强易感高危人群监测,早期采取有针对性的预防对策,利于降低老年精神病患者医院感染率,提高医院感染管理工作质量。

关键词:【关键词】精神病;医院感染;因素;Logistic;预防

ABSTRACT

【 Abstract 】
Objective To study the related factors of nosocomial infection in elderly patients with psychosis and the preventive measures.

Methods A total of 334 elderly patients with psychosis were selected from January 2017 to June 2018 to focus on monitoring patients with nosocomial infections. A multi-factor Logistic regression model was established to summarize and summarize risk factors associated with nosocomial infection in elderly patients with psychosis, and a preventive measure was purposefully formulated.

Results There were 31 nosocomial infections and the infection rate was 9.28%.Age (≥70 years), history of type 2 diabetes, history of chronic obstructive pulmonary disease, type of psychosis (schizophrenia, Alzheimer's disease), skin or mucosal defects, use of antipsychotic drugs (>2 types), Invasive procedures (>2 times), unprotected restraints, anemia, non-prevention of antibacterial agents, use of antibiotics (≥14 days), length of hospital stay (≥28 days), elderly patients with general psychiatric psychiatric conditions, nosocomial infection rate was higher than the hospital infection rate of elderly psychotic patients with the following factors, such as age (<70 years old), history of type 2 diabetes, history of chronic obstructive pulmonary disease, type of mental illness (geriatric depression, brain injury associated with mental disorders), skin no mucosal defect, use of antipsychotics (≤2 types), invasive procedures (≤2 times), protective restriction, absence of anemia, prevention of use of antibiotics, use of antibiotics (<14d), length of stay (<28d), ward environment (good), the difference was statistically significant (P<0.05).Percentage of Th1, Th2, and Th17 in nosocomial patients with psychiatric psychiatric infection was higher than that in uninfected patients. The percentage of CD4+ and CD8+ was lower than that of uninfected patients. The ratio of CD4+/CD8+ was higher than that of uninfected patients. The percentage of FEV1/FVC was lower than that of uninfected patients(P<0.05).Multivariate Logistic regression model was established and the results showed a history of type 2 diabetes, history of chronic obstructive pulmonary disease, types of psychosis, skin or mucosal defects, use of antipsychotic drugs, invasive procedures, anemia, antibiotic use time, CD4+ T cells Subgroups were risk factors for high-risk nosocomial infections in elderly patients with psychosis.Protective restraints, prevention of the use of antibiotics, ward environment, T-lymphocyte subsets, and pulmonary function were protective factors for nosocomial infection in elderly patients with psychosis.

Conclusion   The factors associated with nosocomial infection in elderly patients with psychosis are complex and diverse. To strengthen the monitoring of susceptible high-risk groups and take targeted preventive measures in the early stage will help reduce the rate of nosocomial infection in elderly patients with psychosis and improve the quality of nosocomial infection management.

Key words: 【Key words】Psychosis; Nosocomial infection; Factors; Logistic; Prevention

引用本文 / How to Cite This Article

张月芳.老年精神疾病患者医院感染相关因素筛查及预防对策研究[J]. 国际精神病学杂志, , (): -

参考文献

相关文章