郑聪　黄欣　朱茜

【摘 要】目的：探究神经外科颅内手术患者住院期间发生感染的影响因素及护理措施。方法：选择2017年1月～2019年5月于我院神经外科进行手术治疗的140例患者，观察患者感染类型、病原菌分布，统计患者临床基线资料，分析可能的影响因素，并制定应对感染的护理措施。结果：所有患者中发生感染的有16例，占11.4%，细菌培养结果显示分离病原菌21株，以革兰氏阴性菌和革兰氏阳性菌为主。经单因素及多因素调查和相关性分析结果显示，患者手术时间、患者病程、住院时间、年龄、并发症等是神经外科颅内手术患者发生医院感染的高危影响因素。结论：神经外科颅内手术患者容易发生医院感染，而通过护理措施干预可帮助发生感染患者转归，并减少感染的发生率。

【关键词】神经外科;医院感染;颅内手术;护理;影响因素

Influencing factors and nursing measures of nosocomial infection in patients undergoing neurosurgical intracranial surgery

Zhengcong，Huangxin，Zhuxi（Sichuan North Medical College Affiliated Hospital，Sichuan Nanchong，637000）

Abstract： .Objective to explore the influencing factors and nursing measures of infection in patients undergoing intracranial surgery in Department of neurosurgery.Methods140patients who underwent neurosurgery in our hospital from January2017to May2019were selected to observe the type of infection and the distribution of pathogenic bacteria.The clinical baseline data of patients were analyzed，the possible influencing factors were analyzed，and the nursing measures to deal with the infection were formulated.Results16cases （11.4%） of all patients were infected.The results of bacterial culture showed that21strains of pathogenic bacteria were isolated，mainly Gram-negative bacteria and Gram-positive bacteria.The results of univariate and multivariate investigation and correlation analysis showed that the time of operation，course of disease，length of stay，age and complications were the high risk factors for nosocomial infection in patients undergoing neurosurgical intracranial surgery.Conclusion Neurosurgery intracranial surgery patients are prone to nosocomial infection.Nursing intervention can help patients with infection to turn around and reduce the incidence of infection.

Keywords： Neurosurgery;Hospital infection;Intracranial surgery;Nursing; Influencing factors

【中圖分类号】R651【文献标识码】A【文章编号】1672-3783（2019）12-03--01

神经外科颅内手术患者以颅脑外伤、颅内肿瘤及脑血管疾病患者为主，多数患者病情危重，疾病变化快，加上脑部神经、血管丰富，手术难度大，要求高、时间长，对于广大手术医师的要求极高[1]。流行病学调查结果显示[2-3]，神经外科住院患者的感染发生率为9.0%左右，在各外科科室的感染发生率中位居前列。因此，了解神经外科颅内手术患者感染的发生情况，分析发生感染的病原菌及相关影响因素，对于患者术后的感染预防和治疗具有十分重要的价值。而通过有效的护理措施感染，可以帮助发生感染的患者快速康复，并减少神经外科颅内手术患者的感染发生率，促进患者快速康复，从而提升患者的满意度，改善医患关系。……