深静脉置管患者导管相关性感染的危险因素及干预措施  

Risk factors for catheter-related infections in patients treated with deep venous catheterization and intervention measures

作　　者：张文玉[1] 胡凤华[1] 徐宁[1] 高斌[1] 涂阳科[1] ZHANG Wen-yu HU Feng-hua XU Ning GAO Bin TU Yang-ke(Tianjin First Center Hospital, Tianjin 300192, China)

机构地区：[1]天津市第一中心医院肾内科,天津300192

出　　处：《中华医院感染学杂志》2017年第5期1179-1181,1185,共4页Chinese Journal of Nosocomiology

基　　金：天津市卫生局科技基金资助项目(2013KZ024)

摘　　要：目的分析深静脉置管患者导管相关性感染(CRI)的危险因素及不同干预措施的效果,为临床工作提供依据。方法选取2015年1月-2016年1月医院收治194例行深静脉置管的患者作为研究对象,根据是否出现CRI将患者分为感染组及对照组,比较两组患者的基线资料及置管资料,分析CRI发生的危险因素,比较是否预防性使用抗菌药物(全身)、抗菌药物封管、柠檬酸钠封管对CRI发生率的影响。结果 194例患者中,48例患者出现CRI,发生率24.74%;糖尿病、年龄>75岁、ALB<35g/L、Hb<90g/L、重复置管及长期置管与CRI的发生显著相关(P<0.05);柠檬酸钠封管及抗菌药物封管能降低CRI的发生率,差异有统计学意义(P<0.05);而预防性全身使用抗菌药物对CRI的发生无明显影响。结论深静脉置管患者CRI的发生与多种因素有关,临床上加强对高危患者的干预。OBJECTIVE To investigate the risk factors for catheter-related infections （CRI） in patients treated with deep venous catheterization and observe the effects of different invention measures so as to provide guidance for clinical practice. METHODS A total of 194 patients who were treated with deep venous catheterization in the hospital from Jan 2015 to Jan 2016 were recruited as the study objects and divided into the infection group and the control group according to the status of occurrence of CRI. The baseline data and catheterization data were compared between the two groups of patients, the risk factors for CRI were analyzed, and the influence of prophylactic use of antibiotics （whole body）, antibiotic tube sealing, and sodium citrate tube sealing on incidence of CRI was observed and compared. RESULTS Of the 194 patients, 48 had CRI, with the incidence rate 24.74%, The incidence of CRI was closely associated with diabetic mellitus, more than 75 years of age, ALB level less than 35 g/L, Hb level less than 90 g/L, repetitive catheterization, and long-term catheterization （P〈0. 05）. The sodium citrate tube sealing and antibiotic tube sealing could reduce the incidence of CRI, and there was significant difference （P〈0.05）; however, the prophylactic systemic use of antibiotics did not have significant effect on the incidence of CRI. CONCLUSION The incidence of CRI in the deep venous catheterization patients is associated with multiple factors. It is necessary for the hospital to strengthen the intervention to the high-risk patients.

关 键 词：深静脉置管 导管相关性感染(CRI) 危险因素 

分 类 号：R472[医药卫生—护理学]