危重患者导管相关性血流感染危险评估的应用研究  

Risk assessment of catheter related bloodstream infections in critical patients

作　　者：陈丽燕[1] 邱秀媚[1] 牛玉娟[1] 林丽霞[1] 麦淑珠 

机构地区：[1]海南医学院附属医院急诊科,海南海口570102

出　　处：《中华医院感染学杂志》2015年第4期845-846,853,共3页Chinese Journal of Nosocomiology

基　　金：海南省自然科学基金资助项目(809042)

摘　　要：目的探讨导管相关性血流感染(CRBSI)危险评估在急诊危重患者中的应用效果,为其临床应用提供参考依据。方法 2013年1月-2014年5月随机选取200例医院急诊重症监护病房行中心静脉置管(CVC)的危重患者为研究对象,均给予CRBSI危险评估,对可能潜在的危险因素进行分析,应用SPSS17.0统计软件对数据进行处理。结果 200例行CVC的急诊重症患者中有11例发生CRBSI,感染率为5.5%;发生血流感染的因素为年龄≥60岁、糖尿病史、使用抗菌药物、导管管径≥16cm、导管留置时间≥5d、白蛋白水平<40g/L,其与急诊重症患者CRBSI发生存在相关性,差异有统计学意义(P<0.05);多因素显示,糖尿病史、导管留置时间的延长及白蛋白水平低下是急诊重症患者CRBSI发生的独立危险因素(P<0.05)。结论急诊重症监护病房行CVC治疗的患者给予CRBSI危险评估取得了较好的临床效果,更有效的预防了CRBSI的发生,且缩短患者的置管、住院时间,值得临床推广应用。OBJECTIVE To analyze the risk assessment of catheter related bloodstream infections（CRBSI）in critical patients so as to provide reference for clinical application of risk assessment.METHODS Totally 200 critical patients with central venous catheter（CVC）in our hospital during Jan.2013 to May 2014 were randomly selected.Patients were given CRBSI risk assessment.The potential risk factors were analyzed.Data were processed by the software SPSS17.0.RESULTS There were 11 patients with CRBSI in the 200 critical patients receiving CVC,and the incidence of infection was 5.5%.The factors for bloodstream infections included age≥60years,history of diabetes,use of antibiotics,tube diameter≥16cm,catheter indwelling time≥5d,and albumin level〈40g/L.There was correlation between these factors and CRBSI,with statistical significance（P〈0.05）.Multiple factors showed that history of diabetes,catheter indwelling time and low albumin level were independent risk factors for occurrence of CRBSI（P〈0.05）.CONCLUSIONS CRBSI risk assessment for patients with CVC in the emergent intensive care unit achieved good clinical efficacy,effectively reduced the incidence of CRBSI and shortened catheter indwelling time and hospitalization time,which was worthy of clinical promotion.

关 键 词：导管相关性血流感染 危重患者 中心静脉置管 危险评估 

分 类 号：R181.32[医药卫生—流行病学]