急诊重症监护病房中心静脉导管相关感染的病原学及危险因素分析

目的了解急诊重症监护病房（ICU）中心静脉导管相关感染（CVC-RI）的病原菌特点和危险因素。方法对急诊ICU 2006年1月至2008年12月放置中心静脉导管并符合CVC—RI诊断标准，细菌学检查均阳性的103例患者进行回顾性调查分析。结果CVC—RI病原菌中革兰阳性菌（37．9％，39／103）和革兰阴性菌（42．7％，44／103）发生感染的比例差异无统计学意义。CVC—RI与使用导管腔数、置管时间、置管部位有关。锁骨下静脉置管发生感染的比例最低。结论应尽量选择在锁骨下静脉置管，控制置管时间和导管腔数，注意监测病原菌菌谱的变化。预防重点是避免导管腔内外的污染。

Analyzing etiology of central venous catheter related infections and risk factor in emergency intensive care unit

Objective To investigate the feature of pathogenic bacteria in central venous catheter related infection （CVC-RI）and risk factor in the emergency intensive care unit （ICU）. Methods One hundred and three patients were checked out bacteria from January 2006 to December 2008 in the ICU who were central venous catheter and corresponded with diagnostic criteria for CVC-RL They were analyzed retrospectively. Results The ratio between Gram-postive bacteria （37.9%, 39/103 ） and Gram-negative bacteria （42.7%, 44/103 ） were not statistically significant, however, CVC-RI was related to applying ductal number, duct keeping on time and elect location. Duct staying in subclavian vein had the fewest chance. Conclusions It would be better to choose duct staying in subclavian vein, control remaining time and luminal number, and monitor changing pathogenic bacteria strictly. Main measures are taken to evade the pollution on the ental and external lumina.