429例儿童血液病患者医院感染病例调查分析

摘要/Abstract

摘要： 目的探讨儿童血液病患者医院感染的相关因素及预防措施。方法对北京京都儿童医院2019年1月—2021年12月因血液病住院发生医院感染的429例患儿感染部位、危险因素等进行回顾性分析。结果血液病住院患儿8 858例,发生429例医院感染病例,医院感染发生率为4.84%,且恶性血液病医院感染发生率明显高于非恶性血液病,差异有统计学意义（P<0.05）。其中住院期间有有创操作3 671例,发生医院感染310例,占感染例数的72.26%;429例医院感染病例感染部位以血流感染为主,占42.62%;住院时间≥30 d的感染发生率最高,共359例,占84.07%,住院患者时间延长是发生医院感染的危险因素;化疗后使用层流床的医院感染发生率为3.45%,未使用层流床的医院感染发生率为8.05%,将化疗后粒细胞缺乏患儿安排入住层流病房,能够有效降低住院感染发生率;使用抗生素3 d及以上患儿医院感染发生率明显高于未使用抗生素或使用时间不超过24 h的患儿。结论血液病患儿是医院感染的高危人群,血液病患儿住院期间进行有创操作、住院时间>30 d、使用抗生素>7 d是血液住院患儿医院感染的独立危险因素。

关键词: 儿童血液病, 医院感染, 层流床, 有创操作, 危险因素

Abstract: Objective To explore the related factors and preventive measures of nosocomial infection in children with hematological diseases. Methods The infection site and risk factors of 429 children with nosocomial infection in our hospital from January 2019 to December 2021 were analyzed retrospectively. Results Among 8 858 hospitalized children with hematological diseases, 429 cases of hospital infection occurred, and the incidence of hospital infection was 4.84%, and the incidence of nosocomial infection of malignant hematological diseases was significantly higher than that of non-malignant hematological diseases, and the difference was statistically significant (P<0.05). Among them, 3 671 cases had invasive operation during hospitalization, 310 cases had hospital infection, accounting for 72.26% of the total number of infections; 429 cases of nosocomial infection were mainly infected by blood flow, accounting for 42.62%; 359 cases (84.07%) had the highest incidence of nosocomial infection when the length of stay was ≥ 30 days; the incidence of hospital infection with laminar flow bed after chemotherapy was 3.45%, and the incidence of hospital infection without laminar flow bed was 8.05%. Children with agranulocytosis after chemotherapy were assigned to laminar flow ward, which could effectively reduce the incidence of hospital infection; the incidence of hospital infection was significantly higher in patients who used antibiotics for 3 days or more than in those who did not use antibiotics or who used antibiotics for less than 24 hours. Conclusion Children with hematological diseases are at high risk of hospital infection. Invasive operation during hospitalization, hospitalization time>30 days, and use of antibiotics >7 days are independent risk factors of hospital infection in children with hematological diseases.

Key words: blood diseases in children, hospital infection, laminar flow bed, invasive operation, risk factors

中图分类号:

R552

陆海丽. 429例儿童血液病患者医院感染病例调查分析[J]. 中华养生保健, 2023, 41(5): 8-11.

LU Hai-li. Investigation and Analysis of 429 Cases of Nosocomial Infection in Children with Hematological Diseases[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(5): 8-11.

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