ICU导管相关血流感染危险因素分析和干预.docVIP

ICU导管相关血流感染危险因素分析和干预 　　[摘要] 目的：观察医院重症监护病房（ICU）静脉导管相关血流感染（CRBSI）的危险因素，为采取干预措施提供科学的政策依据。方法：对观察组67例CRBSI的危险因素进行回顾性分析，并采取干预措施；同期选择ICU静脉导管置管未发生CRBSI的患者作为对照组。结果：观察组导管留置时间长于对照组（P0.05）。结论：CRBSI的预防重点要尽可能避免置管或早期拔管，严格无菌操作，精通置管技术，加强日常监测和护理，避免交叉感染。 　　[关键词] 重症监护病房；导管相关血流感染；危险因素；分析 　　[中图分类号] R63 [文献标识码]A[文章编号]1674-4721（2011）08（b）-050-02 　　 　　An analysis of the risk factors of ICU catheter-related bloodstream infection and interventions 　　CHEN Yanping，XIAN Huiyi 　　Department of Hemodialgsis Room, Shilong Boai Hospital Affiliated Guangdong Medical College, Guangdong Province, Dongguan 523320, China 　　[Abstract] Objective: To observe the risk factors of ICU catheter-related bloodstream infection (CRBSI) were observed, in order to provide scientific basis for interventions. Methods: The factors of 67 patients with CRBSI in observation group were retrospective analyzed, and had the intervention study. The other patients who were not infected in the corresponding period of catheterization in ICU were taken as control group. Results: The catheter indwelling time of the observation group was longer than the control group (P0.05). Conclusion: Prevention will focus on avoiding catheterization and removing catheter as soon as possible. It is very important to master the technique of catheterization, follow strict aseptic operation, enhance daily care, isolate patients with drug resistance and avoid cross-infection. 　　[Key words] Intensive care unit; Intravascular catheter-related blood stream infections; Risk factors; Analysis 　　 　　重症监护病房（ICU）感染发病率显着高于其他科室[1]。严重的ICU感染者可因感染造成多器官功能衰竭而死亡[2-3]。临床上，随着中心静脉导管的广泛使用，中心静脉导管相关血流感染（catheter-re-lated bloodstream infection，CRBSI）也随之日益增加，占ICU医院感染相关并发症的第3位[4]，导致患者住院时间延长，病情加重[5]。笔者对2009年1月~2010年10月被确诊为CRBSI的67例患者进行回顾性分析，分析其相关的危险因素，并采取有效干预措施，达到了降低CRBSI的目的。现总结分析报道如下： 　　1 资料与方法 　　1.1 一般资料 　　在679例静脉导管感染患者中，将静脉导管相关血流感染患者67例作为观察组，诊断标准：按照2007年中华医学会重症医学专业委员会指南诊断标准[6]，本组导管相关性血行感染（CRBSI）病例均符合临床诊断标准。其中，男59例，女8例，年龄21~86岁，平均（55.26±8.35）岁，病种：COPD致呼吸衰竭16例，颅脑