ICU导管相关性血流感染的影响因素及防控措施  

The influence factors of ICU catheter related bloodstream infection and prevention and control measures

作　　者：杨波[1] 向永胜[1] 

机构地区：[1]湖北省荆门市第一人民医院血液科,荆门市448000

出　　处：《中华实验和临床感染病杂志（电子版）》2016年第4期413-416,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的分析发生ICU导管相关性血流感染的相关影响因素,并对其防控措施进行探讨。方法选取2013年2月至2015年1月358例于本院ICU中心行动静脉置管的病例资料进行回顾性分析,采用单因素分析数据,对可能与发生导管相关性血流感染相关的因素进行Logistic多因素分析。结果入组患者血流感染的发生率为10.34%,其中年龄(OR=5.214、P=0.000)、穿刺次数(OR=3.823、P=0.000)、置管时间(OR=2.189、P=0.002)、留置部位(OR=2.227,P=0.006)和糖尿病(OR=3.323、P=0.000)均为引发导管相关性血流感染的危险因素,差异均具有统计学意义。37例发生血流感染的病例,分离出38株病原菌,其中G-菌19株(50%),G+菌15株(39.47%),真菌4株(10.53%)。结论年龄、穿刺次数、置管时间和留置部位和糖尿病均为引发ICU导管先惯性血流感染的危险因素,医院应对危险因素加强预防,以降低导管相关性血流感染的发生率。Objective To investigate the related factors of ICU catheter-related bloodstream infections and the preventive measures. Methods Total of 358 cases in the ICU central insert arteriovenous catheter from February 2013 to January 2015 were analyzed, retrospectively by single factor analysis, and the factors of catheter-related bloodstream infections were analyzed by Logistic multivariate analysis. Results The rate of bloodstream infection of the 358 cases was 10.34%. The age（OR = 5.214, P = 0.000）, the number of puncture（OR = 3.823, P = 0.000）, catheterization time（OR = 2.189, P = 0.002）, indwelling position（OR = 2.227, P = 0.006） and diabetes（OR = 3.323, P = 0.000） were risk factors of catheter-related bloodstream infection, all with significant differences. Among the 37 patients with bloodstream infection, 38 strains of pathogenic bacteria were isolated, including 19 strains（50%） of G-bacteria, 15 strains（39.47%）of G＋ bacteria, 4 strains（10.53%） of fungi. Conclusions Age, number of puncture, catheter indwelling time, location and diabetes were the risk factors for triggering ICU catheter inertia bloodstream infection, in order to reduce the incidence of catheter related bloodstream infection, and hospital should strengthen the prevention of the risk factors.

关 键 词：重症监护室 导管插入术 血流感染 相关因素 

分 类 号：R459.7[医药卫生—急诊医学]