ICU中心静脉导管感染的危险因素分析及预防策略  

Risk factors analysis and prevention strategies on ICU central venous catheter infection

作　　者：李晓霞[1] 吴艳春[1] 伍丽霞[1] 曾金莺[1] 李佩颜 

机构地区：[1]广东省江门市人民医院重症医学科,广东江门529020

出　　处：《中国当代医药》2015年第27期195-196,F0003,共3页China Modern Medicine

摘　　要：目的 分析重症监护病房（ICU）中心静脉导管相关感染（CVC-RI）危险因素,探讨预防策略。方法 采用回顾性分析方法,选取2013年1月~2014年12月本院ICU的618例应用CVC患者的病历资料,其中发生CVC-RI的118例设为CVC-RI组,未感染的500例设为对照组,对两组进行单因素分析和多因素Logistic回归分析。结果单因素分析显示,两组的年龄、急性生理与慢性健康评分（APACHE-Ⅱ）、ICU停留时间、总住院时间、留置导管时间、输血、CVC次数≥3次、联合其他置管≥3种、Na＋、白细胞计数、活化部分凝血活酶时间、白蛋白、肌酐、C反应蛋白水平或比重差异有统计学意义（P〈0.05）;多因素Logistic回归分析显示,年龄、APACHE-Ⅱ评分、导管留置时间、联合其他置管≥3种、ALB水平为独立影响因素。结论 ICU患者发生CVC-RI是多种因素共同作用的结果,应建立、健全CVC准入机制,严格落实无菌操作,做好导管护理,合理选择入路,定期更换导管与入路。Objective To analyze the risk factors of central venous catheters related infections (CVC-RI) in intensive care unit (ICU) and explore its prevention strategies. Methods By the retrospective analysis,medical records of 618 pa-tients applied with CVC in ICU of our hospital from January 2013 to December 2014 were selected.Among them,CVC-RI were set in 118 patients as CVC-RI group,and 500 cases without infection were set as control group.The univariate analysis and multivariate Logistic regression analysis were used between two groups. Results Univariate analysis indi-cated that there were statistical differences in two groups ofage,APACHE-II score,ICU stay time,total hospitalization time,ICU residence time,indwelling catheter time,blood transfusion,CVC being no less than 3 times,3 more than com-bined catheters,and levels of Na+,white blood cell count,activated partial thromboplastin time,albumin (ALB),creatinine, C-reactive protein (P<0.05).Multivariate Logistic regression analysis displayed that age,APACHE-II score,indwelling catheter time,3 more than combined catheters and level of ALB were independent factors. Conclusion Occurrence of CVC-RI in ICU patients is caused by many factors.Complete access permission mechanism of CVC should be estab-lished.Strict implementation of aseptic operation,good catheter care,reasonable selection of approach,and periodic re-placement of the catheter and approach are indispensable.

关 键 词：ICU 中心静脉置管 导管感染 危险因素 风险管理 

分 类 号：R472[医药卫生—护理学]