本文選題：腦梗死　切入點(diǎn)：褥瘡感染　出處：《中華醫(yī)院感染學(xué)雜志》2016年17期 　論文類型：期刊論文

【摘要】：目的探討腦梗死患者褥瘡感染的病原學(xué)及其護(hù)理干預(yù)的應(yīng)用效果,為臨床上提高腦梗死患者的護(hù)理效果提供參考依據(jù)。方法選取醫(yī)院2012年10月-2015年9月腦梗死合并褥瘡感染的患者156例,搜集其感染部位分泌物標(biāo)本進(jìn)行培養(yǎng),采用法國生物梅里埃公司Vitek-2Compact型細(xì)菌鑒定及藥敏性分析儀進(jìn)行鑒定分析,根據(jù)藥敏試驗(yàn)結(jié)果制定其預(yù)防策略,進(jìn)行針對性治療,并輔以優(yōu)質(zhì)的護(hù)理干預(yù)。結(jié)果腦梗死合并褥瘡感染患者標(biāo)本中共分離出病原菌148株,其中革蘭陰性菌76株占51.35%,以銅綠假單胞菌、肺炎克雷伯菌、大腸埃希菌、鮑氏不動(dòng)桿菌為主,革蘭陽性菌60株占40.54%,以金黃色葡萄球菌、糞腸球菌、表皮葡萄球菌為主,真菌12株占8.11%,以白色念珠菌為主;革蘭陰性菌中銅綠假單胞菌、肺炎克雷伯菌、大腸埃希菌對青霉素、頭孢呋辛、頭孢噻肟、頭孢哌酮、阿米卡星、妥布霉素等抗菌藥物耐藥率高,對亞胺培南、美羅培南等抗菌藥物較敏感;革蘭陽性菌中金黃色葡萄球菌、糞腸球菌及表皮葡萄球菌對紅霉素、青霉素及左氧氟沙星等抗菌藥物耐藥率較高,但對替考拉寧較敏感。結(jié)論腦梗死合并褥瘡感染的患者病原菌以革蘭陰性菌為主,耐藥性較強(qiáng),臨床治療中應(yīng)以病原菌特點(diǎn)及藥敏結(jié)果為依據(jù)合理應(yīng)用抗菌藥物,以減少新耐藥菌株的形成,對褥瘡感染的患者進(jìn)行有針對性的優(yōu)質(zhì)護(hù)理可以降低醫(yī)院感染的發(fā)生,提高臨床療效。
[Abstract]:Objective to explore the etiology of bedsore infection in patients with cerebral infarction and the effect of nursing intervention. Methods 156 patients with cerebral infarction complicated with bedsore infection from October 2012 to September 2015 were selected to collect the samples from infected sites for culture. Vitek-2Compact type bacteria identification and drug sensitivity analyzer were used to identify and analyze the bacteria. According to the results of drug sensitivity test, the prevention strategy was formulated and targeted treatment was carried out. Results 148 strains of pathogenic bacteria were isolated from the specimens of patients with cerebral infarction and bedsore infection, among which 76 strains of Gram-negative bacteria accounted for 51.35. Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli were used. Acinetobacter baumannii dominated, Gram-positive bacteria accounted for 40.54, Staphylococcus aureus, Enterococcus faecalis, Staphylococcus epidermidis, fungi 12, mainly Candida albicans, Pseudomonas aeruginosa and Klebsiella pneumoniae in Gram-negative bacteria. Escherichia coli has high resistance to penicillin, cefuroxime, cefotaxime, cefoperazone, amikacin and tobramycin, and is more sensitive to imipenem and meropenem. Enterococcus faecalis and Staphylococcus epidermidis were resistant to erythromycin, penicillin and levofloxacin, but sensitive to teicoplanin. Conclusion Gram-negative bacteria are the main pathogens in patients with cerebral infarction and bedsore infection. In order to reduce the formation of new drug-resistant strains, antibiotics should be used rationally according to the characteristics of pathogenic bacteria and the results of drug sensitivity in clinical treatment. The quality nursing of bedsore patients can reduce the incidence of nosocomial infection and improve the clinical efficacy.
【作者單位】： 無錫市中西醫(yī)結(jié)合醫(yī)院急診室;南京中醫(yī)藥大學(xué)護(hù)理學(xué)院;無錫市中西醫(yī)結(jié)合醫(yī)院腦外科;
【基金】：江蘇省科學(xué)基金資助項(xiàng)目(81202958)
【分類號】：R473.74

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