ICU患者发生导管相关性血流感染的原因分析及对策

目的 探讨ICU患者发生导管相关性血流感染(catheter related bloodstream infection,CRBSI)的原因,并制订相应的对策.方法 回顾性分析2010年5月～2011年5月本院实施中心静脉置管治疗的患者751例,其中发生CRBSI 21例,分析发生的原因并制订相应的对策.结果 21例患者发生CRBSI的原因与操作流程不当、患者个体因素、导管的类型和材料、置管部位和时间等有关；其中2例患者进行了导管更换,4例拔除了导管,其余15例感染得到控制,病情稳定转出ICU,1例患者死亡.结论 ICU应制订完善的预防机制,对医护人员进行正规的置管培训,同时加强无菌观念,落实血管内导管的管理与监测,以保证患者的置管安全,预防CRBSI的发生.

Influential factors of central venous catheter-related bloodstream infections in ICU patients and countermeasures

Objective To investigate the influential factors of central venous catheter-related bloodstream infections （CRBSI） in ICU patients so as to develop appropriate Methods The clinical data of 751 ICU patients from May 2010 to May 2011 treated with central venous catheter were retrospectively reviewed to find 21 cases of catheter-related bloodstream infections. The influential factors were analyzed and the countermeasures were worked out. Results Two cases were treated with catheter replacement, four cases with removal of the catheter and the other 15 cases were transferred out of ICU after the infections were controlled stably. One patient died. Conclusion The influential factors of CRBSI include improper operating procedures, individual factors, type and material of the catheter, site and time for catheterization. For ICU wards it needs to formulate a comprehensive preventive mechanism, provide formal catheterization training for medical staff, strengthen the sterile concept, implement the management and monitoring of the intravascular catheter in order to ensure the catheterization safety and prevent the occurrence of CRBSI.