胡丹

[摘要]目的 探讨轮状病毒性腹泻患儿医院感染的相关因素，为临床诊治及预防提供理论依据。方法 选取2013年10月～2016年10月于我院诊断为轮状病毒性腹泻的180例患儿，分别对患儿的年龄、性别、患病季节、营养状况、患儿及家属手卫生、餐具的消毒情况、住院时间等情况进行统计分析。结果 不同性别患儿的轮状病毒性腹泻医院感染发生率比较差异无统计学意义（P>0.05），而不同月龄患儿的患病情况不同，差异有统计学意义（P<0.05），其中7～12月龄的患儿患病率最高；不同季节患儿的患病情况不同，差异有统计学意义（P<0.05），其中9～11月份的患兒患病率最高；同时，Logistic回归分析显示，患儿的营养状况、患儿及家属的手卫生、餐具的消毒情况、住院时间均为儿童患轮状病毒性腹泻的危险因素（P<0.05）。结论 7～12月龄为轮状病毒性腹泻的易感年龄，9～11月份为其高发时间；可从加强患儿的营养、提高患儿及家属的手卫生清洁程度、增加餐具的消毒、缩短住院时间等情况入手，预防及控制医院感染的发生。

[关键词]轮状病毒；腹泻；医院感染

[中图分类号] R373 [文献标识码] A [文章编号] 1674-4721（2017）01（c）-0077-03

[Abstract]Objective To explore the related factors for nosocomial infections in the children with rotavirus diarrhea in the study，and to provide theoretical basis for clinical diagnosis，treatment and prevention.Methods A total of 180 rotavirus diarrhea children with nosocomial infections who were treated in the hospital from October 2013 to October 2016 were enrolled in the study.A survey was conducted for age，gender，season，the nutritional status of children，hand hygiene of the children′s family members，disinfection of tableware，length of hospital stay.Results There was no difference in the incidence of the different gender groups of children（P>0.05）.The difference in the incidence was statistically significant among the different age groups of children（P<0.05），and the incidence of nosocomial infections was highest in children aged 7 and 12 months old.The difference in the incidence was statistically significant among the different season groups of children（P<0.05），and the autumn （from September to November） was the peak.At the same time，the Logistic analysis showed that the risk factors for the nosocomial infections in the children with rotavirus diarrhea included the nutritional status of children，hand hygiene of the children′s family members，disinfection of tableware，length of hospital stay（P<0.05）.Conclusion The children with rotavirus diarrhea aged between 7 and 12 month are at high risk of nosocomial infections，and the incidence is high in autumn（from September to November）.It can be an effective method to prevent and control the nosocomial infections that improving the nutritional status of children，hand hygiene of the children′s family members，disinfection of tableware，and shorten hospital stay.

[Key words]Rotavirus；Diarrhea；Nosocomial infection

腹泻作为小儿最常见的临床疾病，其病因主要分为感染及非感染因素，而感染引起的腹泻具有较高的发病率，影响亦较大[1]。其中常见的致病菌包括：霍乱弧菌、沙门菌、致病性大肠埃希菌、志贺菌等，常见的病毒主要包括轮状病毒、诺如病毒、星状病毒等[2-3]。根据中国疾病预防控制中心调查研究发现，引起儿童感染性腹泻的最常见病因为轮状病毒性腹泻，几乎每个儿童在5岁之前均感染过。轮状病毒主要通过感染小肠的绒毛上皮细胞，引起损伤，进而发生腹泻[4-5]。轮状病毒主要传播途径为粪-口传播，轮状病毒性腹泻的患者、隐性感染者及携带病毒者均是其传染源。由于轮状病毒性腹泻具有较高患病率，为患儿及家属带来极大的痛苦，遂引起了全世界的普遍关注[6]。患儿主要临床表现为腹痛、水样腹泻，无脓血及黏液，可伴有恶心、呕吐、发热等急性胃肠炎表现。另可伴随全身症状，如乏力、头晕、头疼等，严重者可发生酸碱中毒、脱水等危及生命，导致患儿住院时间长，疾病负担较重[7]。 ……