肝衰竭患者导管相关性感染高危因素分析及护理对策  

High risk factor analysis and nursing measures for catheter-related infection in patients with hepatic failure

作　　者：黄敏[1] 李铭[1] 乔梁[1] 朱义朗[1] 

机构地区：[1]阜阳市第二人民医院肝病科,2360015

出　　处：《安徽医学》2012年第1期99-101,共3页Anhui Medical Journal

摘　　要：目的对肝衰竭患者导管相关性感染的高危因素进行监测、分析,探讨相应的护理对策。方法分析359例留置中心静脉导管(CVC)患者的监测资料,比较各项监测参数。结果本组有32例肝衰竭患者发生导管相关性感染,感染率8.91%。导管相关性感染5项相关因素中,导管留置时间、导管穿刺局部渗血或皮下血肿、治疗次数是肝衰竭患者行人工肝治疗时中心静脉导管发生导管相关性感染(CRI)的高危因素。32例CRI中共检出35株病原菌,其中表皮葡萄球菌15株,占46.86%;肠球菌5株,占15.63%;金黄色葡萄球菌4株,占12.50%。结论适时缩短导管留置时间,重视导管接头的护理,改进高温季节换药方法,由专职人员进行穿刺操作,提高一次穿刺成功率,减少局部渗血,建立完善的操作规程和操作流程,培养专职护理人员进行全程导管护理,是降低导管相关性感染发生的有效措施。Objective To monitor and analyze the high risk factors in catheter-related infection in patients with hepatic failure,and explore the corresponding nursing measures.Methods The monitoring data about 359 patients indwelled with central venous catheters（CVC） was retrospectively analyzed,and each monitoring parameter compared.Results 32 patients with hepatic failure suffered catheter-related infection,and the infection rate is 8.91%.Among 5 related factors in catheter-related infection,catheter indwelling time,capillary hemorrhage or subcutaneous hematoma in the catheter puncture location and treating times were thehigh risk factors in catheter-related infection（CRI） when central venous catheters were indwelled in patients with hepatic failure.Totally 35 strains of pathogenic bacteria were detected in the 32 patients with CRI,among which,15 were Staphylococcus epidermidis,which accounted for 46.86%;5 were enterococcus,which accounted for 15.63%;and the other 4 were Staphylococcus aureus,which accounted for 12.50%.Conclusion Shortening catheter indwelling time,paying attention to the nurse on catheter adapter,improving the method of change of dressing in high-temperature seasons,performing puncture procedure by professional staff,increasing single achievement ratio of puncture,reducing local capillary hemorrhage,establishing complete operation procedures and operation flow sheet,and cultivating professional nursing staff to perform full-procedure catheter nursing are effective measures to reduce the incidence of catheter-related infection.

关 键 词：肝衰竭 导管 感染 高危因素 

分 类 号：R473.5[医药卫生—护理学]