经颈胸部长段皮下隧道-颈内静脉-中心静脉导管植入术改善老年患者导管相关性血流感染的临床应用  

Clinical Application of Long Subcutaneous Jugular Thnnel-internal Jugular Vein-central Venous Catheter Implantation to Improve Catheter-related Blood Flow Infection in Elderly Patients

作　　者：王凤玲[1] 马艳娜 孟庆波[3] 王国兴[4] 丁力军[4] 张继峰[4] 刘铁山[4] WANG Feng-ling;MA Yan-na;MENG Qing-bo(People's Hospital of Zunhua,Hebei 064200 China)

机构地区：[1]河北省遵化市人民医院护理部,河北遵化064200 [2]河北省遵化市人民医院儿科,河北遵化064200 [3]河北省遵化市人民医院介入科,河北遵化064200 [4]河北省遵化市人民医院CT/MRI室,河北遵化064200

出　　处：《医学临床研究》2019年第4期625-628,共4页Journal of Clinical Research

基　　金：河北省医学科学研究重点课题(20171403).

摘　　要：【目的】探讨经颈胸部长段皮下隧道,内静膝-中心静脉导管植入术(LSJICC)改善老年患者导管相关性血流感染(CRBSIs)的临床应用价值。【方法】选择2013年1月至2016年10月入住本院需要中心静脉插管治疗的老年患者346例,对所有患者进行为期1年的随访,对CRBSIs患者进行病原菌分布分析,利用Cox回归模型筛选影响CRBSI患者预后的独立影响因素。【结果】患者预后不良率为9.54%;CRBSIs的病原菌分布排名前三位的依次为金黄色葡萄球菌、鲍曼不动杆菌和假丝酵母菌;多因素Cox回归昱示年龄、吸烟、置管时间、染菌类型及疾病类塑对患者术后不良预后有显著影响(P<0.05)。【结论】LSJICC对于预防老年患者CRBSIs有一定的临床价值。【Objective】Clinical value of long subcutaneous jugular tunneHnternal jugular vein-central venous catheter implantation(LSJICC)in improving catheter-related bloodstream infections(CRBSIs)in elderly patients.【Methods】Three hundred and forty-six elderly patients who needed central venous catheterization in our hospital from January 2013 to October 2016 were selected.All patients were followed up for one year.The distribution of pathogens in CRBSSIs patients was analyzed.Cox regression model was used to screen independent influencing factors on the prognosis of CRBSI patients.【Results】The poor prognosis rate was 9,54%.The top three pathogens of CRBSIs were Staphylococcus aureus,Acinetobacter baumannii and Candida.Multivariate Cox regression showed that age,smoking,catheterization time5 type of bacteria and type of disease had significant influence on the poor prognosis of patients after operation(P<0.05)[Conclusion]LSJICC has certain clinical value in preventing CRBSIs in elderly patients.

关 键 词：导管相关性感染/外科学 导管插入术 中心静脉 

分 类 号：R63[医药卫生—外科学]