血液灌流患者留置透析用双腔静脉导管的感染分析及预防

目的 探讨因中毒患者血液灌流时殷静脉留置透析用双腔导管感染的因素并制定预防措施.方法 回顾性分析2009年5月-2011年9月因口服百草枯中毒需进行血液灌流患者进行临床观察.结果 196例中毒患者行血液灌流时使用的透析用双腔静脉导管发生感染28例,感染率为14.3％；＞50岁患者的感染率高,为21.4％,其次为30～50岁,为12.0％；操作者置管经验欠丰富(＜50例)的感染率较高,为15.2％；导管留置时间与感染率呈正相关,留置≥15d患者的感染率为33.3％；患者躁动引起导管与穿刺点处摩擦,引起穿刺点渗血,感染率较高,为15.5％.结论 血液灌流用双腔静脉导管感染的发生率较高,与多种因素有关,通过制定相应预防措施可降低感染的发生率；缩短留置时间、严格无菌操作等是预防感染的重要措施.

Double cavity indwelling catheter-related infections in blood perfusion dialysis patients and prevention measures

OBJECTIVE To explore the related factors for double cavity indwelling catheter-related infections in blood perfusion dialysis patients so as to formulate prevention measures.METHODS The patients who were poisoning with acute oral paraquat from May 2009 to Sep 2011 were respectively analyzed.RESULTS Of 196 poisoned patients who underwent blood perfusion dialysis,double cavity indwelling catheter-related infections occurred in 28 patients with the infection rate of 14.3%;the infection rate of the patients with 50 years of age or older was 21.4%,followed by the patients aged between 30 and 50 years old;the infection rate of the operators who lack experience(less than 50 cases) was 15.2%;the duration of indwelling catheterization was positively correlated with the infection rate,the infection rate of the patients with the duration of catheterization more than 15 days was 33.3%;the infection rate of the friction of catheter and puncture point or the puncture bleeding due the patients’ agitation was 15.5%.CONCLUSION The incidence of double cavity indwelling catheter-related infections is high,which is related to many factors,and it is necessary to formulate corresponding prevention measures to reduce the infections such as shortening the duration of catheterization and strict aseptic operation.Try to shorten the time a lien,strict aseptic manipulation,etc are important measures to prevent infections.