集束化护理措施预防心脏重症患者中心静脉导管相关性血流感染的作用  

Effects of bundle nursing measures on preventing central venous catheter-related bloodstream infections in critically ill cardiac patients

作　　者：王娟[1] 马晶[1] 彭晓红[1] 宋蓓[1] 张莉[1,2] WANG Juan;MA Jing;PENG Xiaohong;SONG Bei;ZHANG Li(Intensive Care Unit,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830000,China;不详)

机构地区：[1]新疆医科大学第一附属医院重症医学科,新疆乌鲁木齐830000 [2]新疆医科大学护理学院,新疆乌鲁木齐830000

出　　处：《中国临床研究》2024年第3期481-484,共4页Chinese Journal of Clinical Research

基　　金：新疆医科大学护理学院青年科研基金资助项目(HLQN-2019-06)。

摘　　要：目的探讨集束化护理对心脏重症患者中心静脉导管相关性血流感染(CRBSI)的预防效果。方法收集新疆医科大学第一附属医院收治的经中心静脉导管治疗的心脏重症患者200例,其中2021年6月至12月行常规护理的100例患者为对照组,2022年1月至6月实施集束化护理的100例患者为试验组。比较两组患者拔管前感染相关指标、细菌培养阳性率、CRBSI发生率、导管置留天数和ICU住院时间。结果试验组拔管前体温、白细胞计数、降钙素原、C反应蛋白等指标的异常比例均低于对照组(P<0.05);试验组发热、血象增高的异常患者细菌培养阳性率[20.00%(5/25)vs 45.95%(17/37),χ^(2)=4.387,P=0.036]、CRBSI发生率(5.00%vs 17.00%,χ^(2)=7.354,P<0.01)均低于对照组,导管留置天数及ICU住院时间短于对照组,差异有统计学意义(P<0.05)。结论对已行中心静脉导管治疗的心脏重症患者采用集束化护理干预,可以减少CRBSI的发生。Objective To explore the preventive effect of bundle nursing in the prevention of central venous catheter-related bloodstream infections(CRBSI) in critically ill cardiac patients.Methods A total of 200 critically ill cardiac patients who received central venous catheter treatment at The First Affiliated Hospital of Xinjiang Medical University from June 2021 to June 2022 were included as the study subjects.Among them,100 patients who received routine nursing from June to December 2021 were assigned to the control group,and 100 patients who received bundle nursing from January to June 2022 were assigned to the experimental group.The infection-related indicators,bacterial culture positivity rate,CRBSI rate,duration of catheter placement,and ICU length of stay were compared between two groups.Results The experimental group had a lower proportion of abnormal temperature,white blood cell count,procalcitonin,C-reactive protein,and other indicators before extubation compared to the control group.Compared with control group,experimental group had a lower bacterial culture positivity rate [20.00%(5/25) vs 45.95%(17/37),χ^(2)=4.387,P=0.036] and infection rate(5.00% vs 17.00%,χ^(2)=7.354,P<0.01),and the duration of catheter placement and length of ICU stay were shorter in the experimental group(P<0.05).Conclusion Bundle nursing intervention in critically ill cardiac patients who have undergone central venous catheter treatment can reduce the incidence of CRBSI.

关 键 词：集束化护理 中心静脉导管 导管相关性血流感染 心脏重症 

分 类 号：R825.4[医药卫生—临床医学]