重症长期卧床老年患者导管相关感染发生调查及影响因素分析  

Investigation of catheter-related infections and analysis of its influencing factors in elderly long-term bedridden patients with critical illness

作　　者：郭大伟[1] 杨雨奇 王朋飞 耿大海 王刚 孙海兵 廖文超 钱骏[1] Guo Dawei;Yang Yuqi;Wang Pengfei;Geng Dahai;Wang Gang;Sun Haibing;Liao Wenchao;Qian Jun(Department of Critical Care Medicine,People s Hospital of Jiangyou City,Jiangyou,Sichuan,621700,P.R.China)

机构地区：[1]江油市人民医院重症医学科,四川江油621700

出　　处：《老年医学与保健》2024年第5期1434-1438,共5页Geriatrics & Health Care

摘　　要：目的探究重症长期卧床老年患者导管相关感染发生的影响因素。方法回顾性分析2022年1月—2024年1月江油市人民医院收治的300例重症监护病房(ICU)长期卧床老年患者的临床资料。观察患者导管相关感染的发生情况(病原菌培养结果阳性),使用单因素分析2组患者的临床资料,再使用多因素Logistic回归分析影响导管相关感染的独立危险因素。结果300例患者中57例发生导管相关感染,纳入发生组;243例未发生纳入未发生组。57例导管相关感染患者中,26例(45.61%)为血流感染、31例(54.39%)为穿刺口感染。主要病原菌为革兰阴性菌。经单因素分析,2组患者卧床时间、合并糖尿病、导管留置时间、插管次数、疾病危重程度、合并恶性肿瘤、皮肤消毒剂使用情况、抗菌药物使用情况之间存在统计学差异(P<0.05);经多因素Logistic回归分析,是否合并糖尿病、导管留置时间、疾病危重程度、合并恶性肿瘤和皮肤消毒剂使用情况是影响患者导管相关感染的独立危险因素(P<0.05)。结论重症长期卧床老年患者导管相关感染受导管留置时间、糖尿病、疾病危重程度、合并恶性肿瘤和皮肤消毒剂使用情况的影响。Objective To explore the influencing factors for catheter-related infection in elderly long-term bedridden patients with critical illness.Methods A retrospective analysis was performed on the clinical data of 300 elderly long-term bedridden patients with critical illness in Intensive Care Unit(ICU)of People s Hospital of Jiangyou City between January 2022 and January 2024.The occurrence of catheter-related infection(the results of pathogen culture were positive)was observed.The clinical data of the two groups were analyzed by univariate analysis,and then independent risk factors for catheter-related infection were analyzed by multivariate logistic regression analysis.Results Among the 300 patients,57 ones developed catheter-related infections and were included in the occurrence group,243 cases did not develop catheter-related infections and were included in the non-occurrence group.Among the 57 infection patients,26 cases(45.61%)were bloodstream infections and 31 ones(54.39%)were puncture site infections.Gram-negative bacteria were main pathogens.Univariate analysis showed that there were significant differences in bed rest time,combined diabetes mellitus,catheter indwelling time,intubation frequency,disease severity,combined malignant tumors,use of skin disinfectants and antibiotics between the two groups(P<0.05).Multivariate logistic regression analysis showed that combined diabetes mellitus,catheter indwelling time,disease severity,combined malignant tumors and use of skin disinfectants were independent risk factors for catheter-related infection(P<0.05).Conclusion The influencing factors for catheter-related infection include catheter indwelling time,combined diabetes mellitus,disease severity,combined malignant tumors and use of skin disinfectants in elderly long-term bedridden patients with critical illness.

关 键 词：老年 重症 卧床 导管相关感染 影响因素 病原菌 糖尿病 

分 类 号：R446.5[医药卫生—诊断学]