735 例危重病患者中心静脉置管感染因素分析.pdfVIP

浙江预防医学 2002 年第 14 卷第 2 期 　Zhejiang Prev Med , February 2002 , Vol 14 , No. 2 ·5 · 735 例危重病患者中心静脉置管感染因素分析 方力争 　陈丽英 　　【摘要】　目的　讨论中心静脉置管感染因素 , 探讨有效防治的对策。方法 　回顾性统计本院 ICU 3 年 中留置CVC 患者 735 例 , 其中发生 CVC - RI 28 例。根据远位感染、留置时间、是否输注 TPN 、插管型号、年 龄及穿刺部位 , 分析 CVC - RI 的相关因素。结果　存在远位感染、CVC 留置时间 7 天、经 CVC 输注 TPN 的 患者、CVC - RI 发生率较高 ; 插管型号、年龄及穿刺部位不同的患者 , CVC - RI 发生率无显著差异。结论 　 危重病患者 CVC - RI 发生与多种因素有关。细菌经导管向血管内迁移及管腔堵塞所致感染为多见 , 并随留置 时间的延长及输注高浓度的糖、脂肪 , CVC - RI 发生率相应增高。严格的无菌操作和护理、合理使用抗生素、 定期更换 CVC 、保持导管通畅是降低 CVC - RI 发生率的关键。 【关键词】　中心静脉　感染因素　预防 中图分类号: R1841 　　　文献标识码 : A 　　文章编号 : (2002) Analysis on the Infective Factors in 735 Patients With Indwelling Catheter in Their Central Venous Fang LiZheng , Chen Liying . The RunRun Shaw Hospital , Zhejiang University School of Medicine , Hangzhou , Zhejiang , 310016 P R China 【ABSTRACT】　OBJECTIVE 　To identify the infection factors of indwelling central venous catheter (CVC) and try to offer some idea of prevention and control. METHODS 　With a retrospective survey , 735 patients with indwelling CVCfrom the ICU of this hospital during the recent 3 years were used to analyze the CVC related infection (CVC - RI) factors including the distant site infection , CVC indwelling time , using or not TPN , the types of CVC , age of patients and the locations of injection. RESULTS 　The CVCRI incidence was higher in the patients with the factors of distant site infection , more than 7 days indwelling time and injecting TPN via CVC. The types of CVC , age of patients and the location of injection were not found any relations with the CVCRI incidence. CONCLUSION 　The CVCRI incidence of patients is related to several factors. It would be considered that the bacteria moving to blood vessel via CVC , blocking in the CVC ,