735例危重病患者中心静脉置管感染因素分析

目的　讨论中心静脉置管感染因素 ,探讨有效防治的对策。方法　回顾性统计本院ICU 3年中留置CVC患者 735例 ,其中发生CVC -RI 2 8例。根据远位感染、留置时间、是否输注TPN、插管型号、年龄及穿刺部位 ,分析CVC -RI的相关因素。结果　存在远位感染、CVC留置时间 >7天、经CVC输注TPN的患者、CVC -RI发生率较高 ;插管型号、年龄及穿刺部位不同的患者 ,CVC -RI发生率无显著差异。结论　危重病患者CVC -RI发生与多种因素有关。细菌经导管向血管内迁移及管腔堵塞所致感染为多见 ,并随留置时间的延长及输注高浓度的糖、脂肪 ,CVC -RI发生率相应增高。严格的无菌操作和护理、合理使用抗生素、定期更换CVC、保持导管通畅是降低CVC -RI发生率的关键

Analysis on the Infective Factors in 735 Patients With Indwelling Catheter in Th eir Central Venous

OBJECTIVE To identify the infection factors of indwelling central venous catheter (CVC) and try to offer some idea of prevention and control. METHODS With a retrospective survey, 735 patients with indwelling CVC from the ICU of this hospital during the recent 3 years were used to analyze the CVC related infection (CVC-RI) factors including the distant site infection, CVC indwelling time, using or not TPN, the types of CVC, age of patients and the locations of injection. RESULTS The CVC RI incidence was higher in the patients with the factors of distant site infection, more than 7 days indwelling time and injecting TPN via CVC. The types of CVC, age of patients and the location of injection were not found any relations with the CVC RI incidence. CONCLUSION The CVC RI incidence of patients is related to several factors. It would be considered that the bacteria moving to blood vessel via CVC, blocking in the CVC, longer indwelling time of CVC might increase the CVC RI incidence.