ICU中心静脉导管相关性感染目标性监测与危险因素分析  

Targeted monitoring of central venous catheter-related infections in ICU and analysis of risk factors

作　　者：唐艳琴[1] 宋秀婵 叶俊琴 李燕 宋娟丽 

机构地区：[1]广东医学院附属石龙博爱医院感染管理科 [2]ICU [3]检验科,广东东莞523325

出　　处：《中华医院感染学杂志》2013年第20期4885-4887,共3页Chinese Journal of Nosocomiology

基　　金：东莞市医疗卫生科技基金项目(201110515028070)

摘　　要：目的探讨ICU患者留置中心静脉导管相关性感染危险因素,以采取有效措施降低感染率。方法采取目标性监测方法,对2011年1月-2013年3月ICU留置中心静脉导管378例患者进行调查与危险因素logistic回归分析。结果导管局部出口感染率为8.0‰导管日,CRBSI率为2.5‰导管日,导管相关性感染主要危险因素有:置管时间≥7d、长期静脉营养治疗、基础疾病严重等;检出革兰阳性菌占48.0%,以葡萄菌属多见;革兰阴性菌占36.0%,真菌占16.0%。结论严格实施置管标准化操作规程,重视导管维护,特别是输注TPN导管的护理,尽量缩短导管留置时间,能有效降低导管相关感染发生。OBJECTIVE To explore the risk factors of central venous catheter-related infections in ICU patients so as to take effective measures to reduce the infection rate. METHODS By means of the targeted monitoring, totally 378 cases of patients who underwent central venous catheterization in ICU from Jan 2011 to Mar 2013 were investigated, then the logistic regression analysis was performed for the risk factors. RESULTS The transeatheter outlet infection rate was 8.0/1000 catheter days, the incidence rate of CRBSI was 2. 5/1000 catheter days. The main risk factors for the catheter-related infections included the catheter indwelling time more than 7 days, long-term parenteral nutrition therapy, and severe underlying diseases. Of the pathogens isolated, the gram- positive bacteria accounted for 48.0%, among which the Staphylococci were the most common, the gram-negative bacteria accounted for 36, 0%, and the fungi accounted for 16. 0%. CONCLUSIONS Enforcing standardized operation rules strictly, attaching great importance to the catheter maintenance, especially the TPN infusion catheter, and trying to shorten the catheter indwelling time can effectively reduce the incidence of catheter：related infections.

关 键 词：重症监护病房 中心静脉导管 导管相关性感染 目标性监测 危险因素 

分 类 号：R181.32[医药卫生—流行病学]