ICU中心静脉导管感染危险因素分析及预防策略.docVIP

ICU中心静脉导管感染危险因素分析及预防策略 　　[摘要] 目的 分析重症监护病房（ICU）中心静脉导管相关感染（CVC-RI）危险因素，探讨预防策略。 方法 采用回顾性分析方法，选取2013年1月～2014年12月本院ICU的618例应用CVC患者的病历资料，其中发生CVC-RI的118例设为CVC-RI组，未感染的500例设为对照组，对两组进行单因素分析和多因素Logistic回归分析。 结果 单因素分析显示，两组的年龄、急性生理与慢性健康评分（APACHE-Ⅱ）、ICU停留时间、总住院时间、留置导管时间、输血、CVC次数≥3次、联合其他置管≥3种、Na+、白细胞计数、活化部分凝血活酶时间、白蛋白、肌酐、C反应蛋白水平或比重差异有统计学意义（P0.05）；多因素Logistic回归分析显示，年龄、APACHE-Ⅱ评分、导管留置时间、联合其他置管≥3种、ALB水平为独立影响因素。 结论 ICU患者发生CVC-RI是多种因素共同作用的结果，应建立、健全CVC准入机制，严格落实无菌操作，做好导管护理，合理选择入路，定期更换导管与入路。 　　[关键词] ICU；中心静脉置管；导管感染；危险因素；风险管理 　　[中图分类号] R472 [文献标识码] A [文章编号] 1674-4721（2015）09（c）-0195-03 　　Risk factors analysis and prevention strategies on ICU central venous catheter infection 　　LI Xiao-xia WU Yan-chun WU Li-xia ZENG Jin-ying LI Pei-yan 　　Intensive Care Unit，the People′s Hospital of Jiangmen City in Guangdong Province，Jiangmen 529020，China 　　[Abstract] Objective To analyze the risk factors of central venous catheters related infections（CVC-RI） in intensive care unit（ICU） and explore its prevention strategies. Methods By the retrospective analysis，medical records of 618 patients applied with CVC in ICU of our hospital from January 2013 to December 2014 were selected.Among them，CVC-RI were set in 118 patients as CVC-RI group，and 500 cases without infection were set as control group.The univariate analysis and multivariate Logistic regression analysis were used between two groups. Results Univariate analysis indicated that there were statistical differences in two groups ofage，APACHE-Ⅱ score，ICU stay time，total hospitalization time，ICU residence time，indwelling catheter time，blood transfusion，CVC being no less than 3 times，3 more than combined catheters，and levels of Na+，white blood cell count，activated partial thromboplastin time，albumin（ALB），creatinine，C-reactive protein（P0.05）.Multivariate Logistic regression analysis displayed that age，APACHE-Ⅱ score，indwelling catheter time，3 more than combined catheters and level of ALB were independent factors. Conclusion Occurrence of CVC-RI in