ICU中心静脉导管相关性感染危险因素分析与干预研究.docVIP

ICU中心静脉导管相关性感染危险因素分析与干预研究 　　[摘要]目的 对ICU中心静脉导管相关性感染的危险因素和干预进行探讨和分析。方法 对该院2012年12月―2013年12月ICU病房收治的行中心静脉置管术360例次患者作为研究对象，其中发生导管感染患者78例，对他们的临床特点、危险因素和干预的关系进行研究。结果 ①ICU中心静脉导管相关性感染总的感染率为：21.67%，其中股静脉、颈静脉和锁骨下静脉插管的感染率分别为33.33%、21.18%和18.60%，其中股静脉置管最高，锁骨下静脉最低（P0.05）。② 置管术后第1、2、3、4周末期时的感染率分别为13.33%、18.46%、24.76%和30.77%，结果显示导管留置的时间越长，感染发生率越高（P0.05）。③单腔导管留置感染率为16.67%，显著低于双腔导管留置的33.33%。④导管留置后78次的感染中有38次为革兰阳性菌感染，感染率为48.71%，有27次为革兰阴性菌感染，感染率为34.61%，有13次为真菌感染，感染率为16.67%。结论 严格中心静脉置管各阶段的管理，提高患者机体免疫力，缩短置管时间，加强医护人员手卫生的管理和穿刺部位消毒，对降低中心静脉置管相关性感染的发生具有非常重要的作用。 　　[关键词]ICU；中心静脉导管；相关性感染；危险因素 　　[中图分类号]R472 [文献标识码]A [文章编号]1674-0742（2015）03（c）-0026-03 　　[Abstract] Objective To explore and analyze the risk of venous catheter related infection factors and intervention of ICU center. Methods 360 cases of patients who were treated by central venous in our hospital in 2012 December -2013 year in December ICU ward catheterization were involved as the research object. The incidence of catheter infection were 78 cases， who were studied the relationship between clinical characteristics、risk factors and intervention. Results The total CRI was 21.67%， and the femoral vein， jugular and subclavian vein catheter infection rates were 33.33%， 21.18% and 18.60% respectively. The infection rate of femoral vein catheterization was maximum， well the rate of subclavian was vein minimum（P0.05）. After the CVC， the rate of CRI was 13.33%， 18.46%， 24.76% and 30.77%， when it was in the end of the first second thirdly and fourthly week（P0.05）. The single lumen catheter infection rate was16.67 %， which was significant different to the double lumen catheters 33.33%. The gram positive bacteria， gram negative bacteria and fungi infection rates were 48.71%， 34.61% and16.67% respectively（P0.05）. Conclusion Strict central venous catheter each stage management of patients， improve immunity， shortening the time of catheter， strengthen the disinfection of hand hygiene of medical staff management and the puncture site， is very i