肿瘤患者医院感染危险因素的条件Logistic回归分析及干预措施

目的探讨恶性肿瘤患者发生医院感染的可疑危险因素、主要危险因素、保护因素，为恶性肿瘤患者医院感染的预防提供可参考的资料。方法采用1：2病例一对照研究设计，回顾性调查方法，用条件Logistic回归分析方法。结果单因素条件Logistic分析筛选出17个具有显著统计学意义的危险因素，多因素条件Logistic逐步回归分析，筛选出14个具有统计学意义的危险因素。结论化疗、抗菌药物、年龄、免疫抑制剂、合并糖尿病、肿瘤分期、侵入性操作、住院天数、肿瘤转移是肿瘤患者医院感染发病的促进因素。白细胞、病房床位设置、医疗环境消毒、生活质量、营养状况是肿瘤患者医院感染发病的保护因素。对医院感染发病风险高的恶性肿瘤患者，除积极作好相应的预防外，实行早期干预，可以降低肿瘤患者医院感染的发病率。

Analysis of factors influencing nosocomiai infection in patients wigh malignant tumor by using logistic regression

Objective To explore the main risk factors of nosocomial infection in patients with malignant tumor and the interactions and joint actions among these factors, then to evaluate the relative importance among these risk factors and interactions on nosocomial infection in patients with malignant tumor. Also, to probe into the protecting factors and to calculate the approximate recurrence risk of nosocomial infection in patients with malignant tumor to provide the data for prevention. Methods A hospital- based 1：2 matched case-control study design and conditional logistic regression analysis were applied to our epidemiological study. Results By univariate conditional Logistic regression analysis, 17 risk factors were found with statistical significance. Partial correlation analysis was conducted on the 14 variables. Conclusion 9 factors including age,hospital stay,antibacterials,virulence manipulateon,tumor stage,immune depressant,chemotherapy,diabetes mellitus ,tumor metastasis are promoting factors of nosocomial infection in patients with malignant tumor, while peripheral white blood cell population, disinfection, hospital room installation ,quality of life,nutritional state are the protecting factors of nosocomial infection in patients with malignant tumor. Clinicians and consultants should identify the risk factors and carry out intervention as early as possible to realize the primary prevention of nosocomial infection in patients with malignant tumor.