Investigation On Risk Factors Of Postoperative Nosocomial Infection In Patients With Esophageal Cancer And Target Monitoring Analysis Of Interventions

ObjectiveTo screen for effective interventions and targeted monitoring of nosocomial infections,investigate the risk factors associated with nosocomial infections in postoperative patients with esophageal cancer in a tertiary hospital.By studying the risk factors of nosocomial infection,nosocomial infection rate,nosocomial infection rate at different sites,nosocomial infection rate at different periods after operation,patient sample submission status and hospitalization expenses before and after intervention,the incidence and goals of nosocomial infection after esophageal cancer are analyzed.The effectiveness of the monitoring measures are discussed,and the application value of targeted surveillance for reducing postoperative nosocomial infections after esophageal cancer are explored.From the perspective of economics,the impact of targeted monitoring interventions on reducing nosocomial infections are discussed,which should cause medical workers to pay attention.MethodsUsing the cluster sampling method,and the nosocomial infection management surveillance system,we retrospectively investigate the data of 81 patients with esophageal cancer surgery from July 2015 to December 2015,analyse risk factors for nosocomial infection,and use Delphi method to screen effective intervention measures."Targeted surveillance report for postoperative nosocomial infection of esophageal cancer"is used to monitor nosocomial infection in 79 cases of esophageal cancer patients from January2016 to June 2016.The effects of targeted surveillance before and after targeted monitoring are verified by nosocomial infection rate,nosocomial infection rate in different sites,nosocomial infection rate at different postoperative times,specimen submissions,and hospitalization costs of postoperative patients with esophageal cancer.Logistic regression analysis is used to screen the risk factors for nosocomial infection in postoperative patients with esophageal cancer.Thec~2 test is used to compare pre-and post-intervention infection rates.Two independent samples of t-test is used to analyse the difference in hospitalization costs before and after the intervention and the infection group and non-infection.Results:1.Through analysis of clinical case information of patients undergoing esophageal cancer resection between July 2015 and December 2015,we find that age,diabetes,days of preoperative hospital stay,operation time,length of surgical incision,smoking are high risk factors for nosocomial infection(P<0.05).2.The Delphi method is used to screen out effective interventions for prevention and control of nosocomial infections in esophageal cancer patients,and a survey form for targeted monitoring interventions is drawn up.3.The intervention of patients undergoing esophageal cancer resection from January2016 to June 2016 is performed through targeted monitoring.After the intervention,the postoperative hospital infection rate drops from 35.8%to 16.46%.After intervention of risk factors,the postoperative nosocomial infection rate of esophageal cancer patients with the same risk factors is significantly lower than before intervention(P<0.05).The rate of nosocomial infection in patients with esophageal cancer at the high postoperative site is significantly lower after the intervention(P<0.05),and with the Specimen-related indicators.The intervention measures are effective in controlling the nosocomial infection rate in patients with esophageal cancer surgery>6 days postoperatively,operative time?180 minutes,surgical incision length<25cm,and hyperglycemia(P<0.05).The costs of hospitalization in patients with esophageal cancer surgery before and after intervention are significantly higher than that in non-hospital infection group(P<0.05).The costs of nosocomial infection group after intervention are significantly lower than that before intervention(P<0.05),especially western medicine costs and inspection fees.Costs before and after intervention in non-hospital infection patients do not change significantly(P>0.05).Conclusion:Age,diabetes,days of preoperative hospital stay,operative time,surgical incision length and smoking are the major risk factors for nosocomial infection after esophageal cancer.Perioperative effective monitoring measures can be used to intervene in risk factors to effectively reduce the incidence of nosocomial infection after esophageal cancer resection.In addition,intervention measures have a certain impact on reducing the cost of hospitalization.Hospital infections increase the economic loss of patients after esophageal cancer and need to pay attention.