最大化无菌屏障在预防导管相关血流感染中的作用  

Role of maximal sterile barrier precaution on preventing catheter-related bloodstream infection

作　　者：董磊[1] 刘壮[1] 段美丽[1] 李昂[1] 

机构地区：[1]北京市重症医学质量控制和改进中心首都医科大学附属北京友谊医院,北京100050

出　　处：《中国感染控制杂志》2017年第7期627-630,共4页Chinese Journal of Infection Control

摘　　要：目的了解重症医学科病房深静脉、动脉插管患者采用最大化无菌屏障,对预防导管相关血流感染(CRBSI)的作用。方法 2011年9月—2014年4月回顾性收集北京友谊医院重症医学科深静脉、动脉插管患者996例,根据患者是否实行最大化无菌屏障,分为标准无菌屏障组(SSB组,2011年9月—2012年12月,560人次)和最大化无菌屏障组(MSB组,2013年1月—2014年4月,436人次),比较两组患者CRBSI发生情况、病死率等。结果 SSB和MSB组患者插管部位构成比较,差异无统计学意义(χ~2=6.750,P=0.08)。SSB组CRBSI发生率为2.41‰(1.64‰~4.02‰),MSB组为1.91‰(0‰~4.56‰),经秩和检验比较,差异无统计学意义(Z=-0.057,P>0.05);SSB组发生CRBSI 24例(4.29%),MSB组发生CRBSI 26例(5.96%),两组比较,差异无统计学意义(χ~2=1.447,P>0.05)。SSB组病死率为(18.43±5.53)%,MSB组病死率为(11.68±4.14)%,经独立样本t检验,差异有统计学意义(t=3.907,P<0.05)。结论最大化无菌屏障未减少CRBSI的发生。ObjectiveTo investigate the effect of maximal sterile barrier precaution during deep venous/arterial catheterization on preventing catheterrelated bloodstream infection （CRBSI） in patients in the department of critical care medicine. Methods996 patients who were hospitalized in Beijing Friendship Hospital and underwent deep venous/arterial catheterization from September 2011 to April 2014 were analyzed retrospectively, patients were divided into standard sterile barrier precaution group （SSB group, September 2011December 2012, n=560） and maximal sterile barrier precaution group （MSB group, January 2013April 2014, n=436） based on whether they received maximal sterile barrier precaution, incidence of CRBSI and mortality were compared between two groups. ResultsThere was no statistical difference in constitute of intubation sites between patients in SSB group and MSB group（χ^2=6.750,P=0.08）. The incidence of CRBSI per 1 000 catheter days in SSB group and MSB group were 2.41‰（1.64‰-4.02‰）and 1.91‰（0‰-4.56‰）respectively,rank test revealed no significant difference（Z=-0.057,P〉0.05）;24 （4.29%）patients in SSB group and 26（5.96%） patients in MSB group developed CRBSI, difference between two groups was not statistically significant（χ^2=1.447,P〉0.05）. The mortality in SSB group and MSB group were （18.43±5.53）% and （11.68±4.14）% respectively,independent sample ttest revealed that difference was significant（t=3.907,P〈0.05）. ConclusionMaximal sterile barrier precaution did not reduce the incidence of CRBSI.

关 键 词：重症医学科 最大化无菌屏障 导管相关血流感染 医院感染 

分 类 号：R181.32[医药卫生—流行病学]