经外周静脉置入中心静脉导管置管患者医院感染病原学特征与干预效果  

Pathogenic features and intervention effect of nosocomial infections after PICC intubation

作　　者：吴清霞[1] 林海燕[2] 林白浪[3] 杨晓阳[4] 王伟[1] 

机构地区：[1]中南大学湘雅医学院附属海口医院护理教研室,海南海口570208 [2]中南大学湘雅医学院附属海口医院静脉治疗中心,海南海口570208 [3]中南大学湘雅医学院附属海口医院护理部,海南海口570208 [4]中南大学湘雅医学院附属海口医院血液科,海南海口570208

出　　处：《中华医院感染学杂志》2016年第3期692-694,共3页Chinese Journal of Nosocomiology

基　　金：海南省卫生和计划生育委员会科研基金资助项目(14A200019)

摘　　要：目的探讨经外周静脉置入中心静脉导管(PICC)置管患者医院感染病原学特征及情景式健康教育的干预效果,为降低感染率提供参考。方法将2014年6月-2015年5月在医院行PICC置管的160例患者,随机分为对照组和试验组各80例,两组患者均给予常规护理方法,对照组采用传统健康教育法进行宣教,试验组采用情景式健康教育模式,比较两组患者医院感染率;收集医院感染患者资料,分析病原菌种类、医院感染的危险因素。结果 160例患者中发生医院感染8例,医院感染率5.0%,其中试验组患者医院感染1例,感染率1.3%,对照组患者医院感染7例,感染率8.8%,试验组患者医院感染率显著低于对照组,两组间比较差异有统计学意义(χ2=4.737,P<0.05);医院感染患者共分离出23株病原菌,其中革兰阳性菌8株占34.8%,革兰阴性菌11株占47.8%,真菌4株占17.4%;患者年龄≥60岁、合并基础疾病、导管留置时间≥3个月是PICC置管后医院感染的高危因素。结论 PICC置管后医院感染病原菌主要是革兰阴性菌,情景式健康教育能够显著降低医院感染率,值得临床推广。OBJECTIVE To explore the pathogenic features and effect of scene health education on nosocomial infections after PICC intubation.METHODS A total of 160 cases of patients with PICC intubation from Jun.2014 to May 2015 were selected and randomly divided into the control group and the experimental group with 80 cases in each group.The patients in the two groups were given conventional nursing,in addition,the control group received the traditional health education,and the experimental group received the scene health education.The nosocomial infection rates of two groups were compared.The data of patients with nosocomial infections were collected,and the risk factors for the infections and the types of the pathogens were analyzed.RESULTS Totally 8out of160 patients had nosocomial infections,the nosocomial infection rate was 5.0%,including 1case in the experimental groups with the infection rate of 1.3% and 7cases in the control group with the infection rate of 8.8%.The incidence of nosocomial infections was significantly lower in the experimental group than in the control group（χ2=4.737,P〈0.05）.There were 23 pathogenic bacteria isolated from 8patients with nosocomial infections,including 8strains of gram positive bacteria accounting for 34.8%,11 strains of gram negative bacteria accounting for 47.8%,and 4strains of fungi accounting for 17.4%.Age of 60 years or older,complication with underlying diseases,and indwelling time more than 3months after the catheter were high risk factors of nosocomial infections in PICC.CONCLUSIONThe pathogenic bacteria of nosocomial infections after PICC are mainly gram negative bacteria,and the scene health education can significantly reduce theincidence of nosocomial infections and is worthy of clinical promotion.

关 键 词：中心静脉导管 医院感染 病原菌 情景式健康教育 

分 类 号：R378[医药卫生—病原生物学]