急诊患者深静脉置管的感染相关因素分析

目的分析急诊患者深静脉置管感染的相关因素，并提出针对性措施。方法选择2009年1月～2012年12月在我院急诊科行深静脉置管的640例患者的临床资料进行回顾性分析，寻找导致感染的相关因素。结果640例深静脉置管患者中有62例发生感染，感染率为9．69％；与深静脉置管感染有关的因素较多，其中年龄方面：观察组的平均年龄为（63．20±10．52）岁，高于对照组的（52．11±9．41）岁，差异具有统计学意义（P〈0．05）；留置时间：观察组为（26．40±5．48）d，高于对照组的（17．30±5．19）d，差异具有统计学意义（P〈0．05）；置管次数：观察组（2．20±0．79）次，高于对照组的（1．30±0．48）次，差异具有统计学意义（P〈0．05）；换药频次：观察组（2．40±0．52）次／d，高于对照组的（1．40±0．52）次／d，差异具有统计学意义（P〈0．05）；插管部位：股静脉插管感染28例，高于颈内静脉及锁骨下静脉插管者，差异具有统计学意义（P〈0．05）；使用刺激性药物、激素及伴随糖尿病等疾病者感染率高于未使用者及无伴随疾病者，差异具有统计学意义（P〈0．05）。通过多因素Logistic回归分析筛选出深静脉置管相关感染与患者的年龄、导管留置时间、置管次数及插管部位有关。结论患者的年龄、导管留置时间、置管次数及插管部位是深静脉置管感染的相关因素。在临床护理工作中应通过有效的护理措施尽量避免或减少这些因素，可以有效降低深静脉置管的感染风险。

Analysis of infection related factors in emergency patients with deep ve- nous catheterization

Objective To analyze the related infection factors in emergency patients with deep venous catheterization, and put forward corresponding measures. Methods Analyzed the clinical data of 640 emergency patients with deep venous catheterization admitted into our hospital from January 2009 to December 2012 retrospectively, and found out the related factors of infection. Results Of the 640 patients with deep venous catheterization, 62 cases occurred infection,and the infection rate was 9.69%; there were many factors related to infection, in age side：the average age of the observation group was （63.20±10.52）, was higher than the control group （52.11±9.41）, there were statistically significant differences between the two groups（P 〈 0.05）; indwelling time： the observation group was （26.40±5.48） days, were higher than the control group （17.30±5.19） days, there were statistically significant difference between the two groups（P 〈 0.05）; intubation times： the observation group were （2.20±0.79） times, were higher than the control group （1.30±0.48） times, there were statistically significant differences between the two groups （P 〈 0.05）; dressing change frequency： the observation group were （2.40±0.52） times a day, were higher than the control group （1.40±0.52） times a day, there was statistically significant differences between the two groups （P 〈 0.05）; intubation site： 28 cases with femoral vein intubation were infected, were higher than that of internal jugular vein or subclavian vein intubation, there were statistically significant differences between them （P 〈 0.05）; in addition, patients who used stimulant drugs, hormone and accompanying diabetes diseases had higher infection rate than those who didn＇t used these drugs and no accompanying diseases, there were statistically significant differences between them （P 〈 0.05）. The multi-factor logistic regression analysis showed that, the infection related factors in emergency patients with deep vein catheter were related with age, catheter indwelling time, intubation times and intubation site. Conclusion Patient＇s age, catheter indwelling time, intubation times and intubation site are the related factors of infection. In the clinical nursing work, we should use effective nursing measures to avoid or reduce these factors, and effectively reduce the infection risk of deep venous catheterization.