持续性质量改进对肝癌患者中心静脉置管相关感染的影响  

Effect of continuous quality improvement on central venous catheter-related infections in liver cancer patients

作　　者：李秀丽[1] 陈秀芳[2] 齐丽贞[3] 邱花叶[1] 刘百百[4] 

机构地区：[1]滨州市人民医院传染科,山东滨州256610 [2]滨州市人民医院家庭病床科,山东滨州256610 [3]滨州市人民医院核医学科,山东滨州256610 [4]滨州市人民医院儿科,山东滨州256610

出　　处：《中华医院感染学杂志》2015年第14期3344-3346,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81101250)

摘　　要：目的评估医院感染管理持续性质量改进对肝癌行颈内中心静脉置管患者相关感染因素,为有效预防控制感染提供依据。方法选取2010年1月-2014年12月243例住院治疗并行颈内静脉置管的肝癌患者为研究对象,根据实施医院管理持续性改进的时间分为对照组145例(改进前)和干预组98例(改进后),观察并比较两组患者颈内中心静脉置管相关感染的发生率。结果干预组98例患者中6例发生中心静脉置管相关感染,发生率为6.12%,其中导管细菌定植3例、导管局部感染1例、导管相关性血流感染2例;对照组患者中有31例发生中心静脉置管相关感染,发生率为21.38%,其中导管细菌定植14例、导管局部感染10例、导管相关性血流感染7例,干预组中心静脉置管相关感染发生率显著低于对照组(P<0.05)。结论医院感染管理持续性质量改进可以明显降低肝癌患者颈内中心静脉置管相关感染的发生率。OBJECTIVE To evaluate the effect of the continuous quality improvement on the internal jugular central venous catheter-related infections in the liver cancer patients so as to effectively control the infections.METHODS A total of 243 liver cancer patients who were hospitalized and underwent the internal jugular vein catheterization from Jan 2010 to Dec 2014 were recruited as the study objects and divided into the control group（before the improvement）with 145 cases and the intervention group（after the improvement）with 98 cases according to the time of implementation of the continuous quality improvement.The incidence of the internal jugular central venous catheter-related infections was observed and compared between the two groups of patients.RESULTS The central venous catheter-related infections occurred in 6of 98 patients in the intervention group with the incidence rate of6.12%,including 3cases with bacterial colonization on catheters,1case of local catheter-related infection,and 2cases of catheter-related bloodstream infections.The central venous catheter-related infections occurred in 31 cases in the control group with the infection rate of 21.38%,including 14 cases with bacterial colonization on catheters,10 cases of local catheter-related infections,and 7cases of catheter-related bloodstream infections;the incidence of the central venous catheter-related infections of the intervention group was significantly lower than that of the control group（P〈0.05）.CONCLUSION As is applied for the management of nosocomial infections,the continuous quality improvement can significantly reduce the incidence of internal jugular central venous catheter-related infections in the liver cancer patients.

关 键 词：医院感染 持续性质量改进 肝癌 中心静脉置管 相关感染 

分 类 号：R197.323[医药卫生—卫生事业管理]