导管相关性血流感染危险因素分析与对策  

Risk factors for catheter-related bloodstream infections and prevention countermeasures

作　　者：肖玲[1] 姜傲[2] 齐凤[3] 李茁[1] 张涛[1] 刘丽秀[4] 

机构地区：[1]吉林大学中日联谊医院新民院区普外科,吉林长春130033 [2]吉林大学中日联谊医院新民院区护理部,吉林长春130033 [3]吉林大学中日联谊医院新民院区血液内科,吉林长春130033 [4]吉林大学中日联谊医院新民院区体检中心,吉林长春130033

出　　处：《中华医院感染学杂志》2015年第17期3985-3986,共2页Chinese Journal of Nosocomiology

基　　金：吉林省科技发展计划基金资助项目(20100725)

摘　　要：目的探讨导管相关性血流感染(CRBSI)的危险因素与预防对策,降低血流感染的发生率。方法选取2008年12月-2013年12月153例CRBSI患者作为研究对象,记录患者感染的发生情况,分析发生感染的相关危险因素及感染病原菌的分布;采用MINKE医院感染管理系统对监测资料进行汇总分析。结果 21例患者感染发生于置管7d内,占13.72%,132例发生置管7d后,占86.28%,153例患者穿刺部位均出现皮肤红肿和化脓;CRBSI发生原因:操作流程不当、置管后护理不规范、导管位置不适宜、导管留置时间过长、患者个体因素;共分离出病原菌312株,其中革兰阴性菌248株占79.49%,革兰阳性菌58株占18.59%;真菌6株占1.92%。结论提高医院感染管理水平,严格按照规范进行操作,加强患者置管后护理可有效控制CRBSI的发生。OBJECTIVE To explore the risk factors for catheter-related bloodstream infections（CRBSI）and put forward the prevention countermeasures so as to reduce the incidence of the bloodstream infections.METHODS A total of 153 patients with CRBSI who were treated in the hospital from Dec 2008 to Dec 2013 were enrolled in the study.The incidence of the infections was recorded,the related risk factors for the infections and the distribution of pathogens causing infections were observed,and the monitoring data were summarized and analyzed by using MINKE nosocomial infection management system.RESULTS Totally 21 patients were infected within 7days of catheterization,accounting for 13.72%;132patients were infected after the catheterization for 7days,accounting for 86.28%;153patients had sin swelling and purulence.The causes of CRBSI included the inappropriate operation procedure,non-standard nursing after catheterization,inappropriate catheterization site,prolonged catheter indwelling time,and individual factors of the patients.A total of 312 strains of pathogens were isolated,including248（79.49%）strains of gram-negative bacteria,58（18.59%）strains of gram-positive bacteria,and 6（1.92%）strains of fungi.CONCLUSIONIt is an effective way to improve the level of management of nosocomial infections,carry out the operations according to the rules and regulations,and strengthen the nursing after the catheterization so as to control the CRBSI.

关 键 词：普通外科 导菅插入术 中心静脉 医院感染 

分 类 号：R181.32[医药卫生—流行病学]