PICC导管穿刺点感染原因分析及护理对策

目的 调查经外周留置中心静脉导管(PICC)留置患者穿刺点感染的原因,探讨有效的预防和护理措施.方法 对352例PICC导管留置患者的穿刺点或分泌物取样做细菌培养,对所得数据进行统计分析,并提出相应的预防措施.结果 352例PICC导管留置患者发生穿刺点感染25例,感染率为7.10％,感染与一次穿刺成功、年龄、留置时间,贴膜更换间隔周期有显著相关性；检出病原菌共21株,以革兰阳性球菌为主,占71.43％,其次为革兰阴性杆菌,占23.81％.结论 PICC导管留置患者穿刺点感染与一次穿刺成功、年龄、留置时间、贴膜更换间隔周期密切相关,应积极采取相应有效的措施,降低PICC导管穿刺点感染的发生率.

Analysis of risk factors for puncture site infections and nursing countermeasures

OBJECTIVE To investigate the causes of puncture site infections in patients indwelling PICC catheter and discuss the effective prevention and control measures.METHODS Of the 352 cases,puncture points or secretions of patients whose PICC catheter were sampled for bacterial culture,the acquired data were statistically analyzed,the corresponding preventive measures were proposed.RESULTS Of the 352 cases with indwelling PICC,there were 25 cases with puncture site infections,the rate of infection was 7.10%,the infection was significantly correlated with the success of a puncture,age,retention duration,and interval period of diaphragm replacement;the infection was not related to the gender and the types of diseases;a total of 21 strains of pathogenic bacteria were detected,mainly including gram-positive cocci(71.43%) and gram-negative bacilli(23.81%).CONCLUSION The puncture site infection in PICC indwelling patients is closely related to the success of a puncture,age,retention duration,and interval period of diaphragm replacement.It should take effective measures actively to reduce the incidence of puncture site infections.