ICU中心静脉导管相关性感染危险因素分析  

Analysis on central venous catheter-related infection risk factors in ICU

作　　者：陈宝珍[1] 罗建[1] 楼炳恒[1] 张伟文[1] 

机构地区：[1]衢州市人民医院重症监护中心,浙江衢州324000

出　　处：《中华医院感染学杂志》2014年第7期1667-1668,1741,共3页Chinese Journal of Nosocomiology

基　　金：衢州市卫生局科技计划基金项目(20081087)

摘　　要：目的探讨ICU中心静脉导管相关性感染危险因素,并提出相关处理对策,为临床预防提供依据。方法收集2011年1月-2012年12月医院ICU中心静脉置管的218例患者临床资料.对其中46例中心静脉导管相关性感染患者的病原菌分布、置管时间和置管部位等进行分析,采用SPSS 17.0统计软件进行统计。结果送检的218例中心静脉导管尖端细菌培养的样本中,阳性46例,阳性率为21.10%;检出病原菌46株,其中革兰阳性菌29株占63.04%,真菌13株占28.26%,革兰阴性菌4株占8.70%;颈内静脉穿刺感染率最高,为43.75%;其次是股静脉穿刺,为37.50%;锁骨下静脉最低,为18.56%;置管时间>7d的感染率为23.89%,显著高于置管时间≤7d的7.89%。结论应加强人员教育培训、严格无菌操作、减少置管时间和建立严格预防体系对防止中心静脉导管感染有重要意义。OBJECTIVE To explore the central venous catheter-related infection risk factors and to find out corre-sponding countermeasures ,aiming at providing a basis for clinical nursing .METHODS Clinical data of 218 cases of patients treated through central venous catheterization in the ICU department of our hospital between Jan .2011 and Dec .2012 were collected ,and an analysis was carried out on pathogenic ratio and composition ,catheterization time and sites ,etc to the 46 cases of patients with central venous catheterization related infections .SPSS 17 .0 software was used for statisticad analysis .RESULTS Of the 218 cases of censorship of central venous catheter tip bacterial cultivation samples ,46 were positive with a positive rate of 21 .1% .A total of 46 strains of pathogens were detected ,of which 29 cases were gram-positive ,accounting for 63 .04% ;13 cases were fungal infection , accounting for 28 .26% ;4 cases were gram-negative ,accounting for 8 .7% .The occurrence of internal jugular vein puncture infection was the highest with an occurrence rate of 43 .75% ;followed by femoral vein puncture with a rate of 37 .50% .Subclavian vein puncture had the lowest rate with an occurrence rate of 18 .56% .The positive rate for catheterization time longer than seven days was 23 .89% ,significantly longer than that of a catheterization time equal to or shorter than seven days with a positive rate of 7 .89% .CONCLUSION It is significant for hospitals to strengthen personnel training ,to implement strict aseptic operation ,reduce catheterization time and establish strict preventive system .

关 键 词：中心静脉导管 导管相关性感染 病原菌 

分 类 号：R181.32[医药卫生—流行病学]