精準護理在神經外科多重耐藥菌感染控制中的應用

摘要：目的 探討精準護理在神經外科多重耐藥菌感染控制中的應用。方法 2014年3月～2015年2月在神經外科住院的多重耐藥菌感染患者有124例，為對照組，2015年3月～2016年2月在神經外科住院的多重耐藥菌感染患者192例，為觀察組；對照組給予傳統護理方法，對觀察組患者采取一系列有針對性的精準護理措施，包括加強MDRO知識宣傳教育、提高醫務人員手衛生意識、采取正確的隔離防范措施等。然后對對照組和觀察組感染情況進行對比分析，評價神經外科多重耐藥菌感染控制效果。結果 觀察組與對照組的腫瘤多重耐藥菌感染控制率分別為74.50% （143/192）和45.2% （56/124），組間對比差異有統計學意義（P<0.05）。觀察組的病人肺部感染、顱內感染、尿路感染等發生情況明顯少于對照組（P<0.05）。觀察組的病人住院時間為（39.43±6.39）d，而對照組分別為（53.04±16.45）d，組間對比（P<0.05）。結論 相對傳統護理方法，精準護理能更好控制神經外科多重耐藥菌感染，從而縮短患者住院時間，促進患者康復。

關鍵詞：精準護理；神經外科；多重耐藥菌

Application of Precision Nursing in the Control of Multi-drug Resistant Bacteria Infection in the Department of Neurosurgery

SUN Cui，LI Li，WANG Dong-mei，YANG Wen-jiao

（Department of Neurosurgery，Shiyan Taihe Hospital/The Affiliated Hospital of Hubei Medical College，Shiyan 442000，Hubei，China）

Abstract：Objective Discuss the Application which of precision nursing in the control of multi-drug resistant bacteria infection in the department of neurosurgery. Methods 124cases admitted as control group between March，2014 and February，2015 in our department were investigated and apply traditional nursing to them.192 such cases were investigated as observation group， and they were given precision care， including strengthen the propaganda and the education of MDRO， improve the hospital staff's awareness of hand hygiene， and take correct quarantine measures， ect. Contrast and analyse the infection between the control group and observation group， and evaluate the effect of controlling the multiple resistant bacteria. Results The controlling rate of multiple resistant bacteria in observation group is 74.50%（143/192），and in control group is 45.2%（56/124），showing a significant difference between each group（P<0.05）.The observation group's patients' lung infection， intracal infection and urinary tract infection cases are significantly less than the control group （P<0.05）.The time in hospital of observation group are 39.43±6.39，and the control group are 53.04±16.45.There is a difference in the groups（P<0.05）.Conclusion Compare to the traditional caring ways， the precision nursing can control the multiple resistant bacteria infection in neurosurgery， so that the time in hospital can be shorten and it helps the patients return to health.

Key words：Precision nursing；Neurosurgery；Multi-drug resistant bacteria

多重耐藥菌（multidrug-resistant organism，MDRO），主要是指對臨床使用的3類或3類以上抗菌藥物同時呈現耐藥的細菌[1]。多重耐藥菌所造成的人力和經濟花費巨大，可導致患者的住院時間延長，治療費用增加，病死率升高[2]。同時抗菌藥物不良反應的風險增加，且多重耐藥菌患者本身也極易成為傳播源。因此，如何有效減少多重耐藥菌的產生，阻斷多重耐藥菌的傳播，引起了醫學界、政府和社會的廣泛關注[3]。而神經外科病人由于手術創傷大，病情危重，接受中心靜脈插管、機械通氣、泌尿道插管等各種侵入性操作機率高，住院時間長等原因[4]，使得MDRO發生率比普通患者高。……