老年患者PICC导管相关感染的临床分析及护理

目的 观察老年患者PICC置管后发生导管相关感染（CRI）的一般情况、病原学及导管培养情况,并寻找有效的护理策略.方法 采用回顾性分析,对92例老年PICC置管患者的一般情况、病原学及导管培养情况进行调查分析.结果 92例PICC置管患者中,可确诊的导管相关感染患者56例,占60.87%;置管后发生感染的时间为9～366 d,平均（93.14±82.76）d;在确诊病例的病原菌中,表皮葡萄球菌、近平滑念珠菌、鲍蔓不动杆菌占前三位.导管头培养的阳性率较高占60.71%.结论 老年患者,尤其是高龄老年患者,机体抵抗力低,合并多种疾病,易发生CRI,但不排除存在医院交叉感染的可能性.因此,应加强无菌操作、日常观察护理及相关健康宣教.

Clinical analysis of PICC-related infections and nursing strategies in the elderly patients

Objective To observe the general conditions, pathogens and catheter culture of PICC-related infections in the elderly patients and to identify effective nursing strategies. Methods By means of retrospective analysis, the general conditions, pathogens and catheter culture in 92 elderly patients with PICC were investigated. Results 56 elderly patients with PICC were diagnosed with PICC-related infections (60.87%). The average interval of infections after PICC settling was (93.14 ± 82.76 )days. Staphylococcus epidermidis, Candida parapsilosis and acinetobacter were the dominating pathogens. The positive rate of the catheter tips culture was 60.71%. Conclusions Elderly patients generally have low resistance and concurrent diseases, thus are susceptible to PICC-related infections (not exclusive of nosocomial infections). Therefore,aseptic operation, daily observation and nursing and related healthy education should be strengthened.