外周中心静脉导管感染相关因素分析及预防

目的 分析外周中心静脉导管(PICC)置管后发生医院感染的相关因素,并探讨预防PICC置管感染的措施.方法 选取行PICC置管患者600例作为研究对象,按照是否发生置管后感染将其分为感染组和非感染组,对两组患者的各种暴露因子与发生感染进行相关性分析,并根据分析结果结合临床经验探讨预防PICC置管感染的措施.结果 患者性别、置管所选静脉位置的OR值均＜2.00,差异无统计学意义；而患者年龄＞60岁、基础疾病中包含糖尿病、置管人员年资＜5年、置管时间＞180 d、静脉输注液体种类的OR值分别为2.78、2.57、2.09、2.77、2.45,差异均有统计学意义(P＜0.05),上述因素中,患者年龄＞60岁、患糖尿病、置管护理人员年资＜5年、静脉输注液体为完全胃肠外营养、导管留置时间＞180 d者比例为:23.18％、11.72％、12.97％、27.80％、9.50％.结论 PICC置管后发生感染严重影响患者的康复效率,重者甚至导致严重后果,临床过程中,医护人员应根据患者实际情况,制定严密的治疗及护理方案,尽量降低感染率,确保患者获得良好治疗.

Related factors for peripherally inserted central venous catheter-associated infections and prevention countermeasures

OBJECTIVE To explore the related factors for peripherally inserted central venous catheter-associated infections and put forward the measures for the prevention of PICC infections.METHODS A total of 600 PICC catheter patients were set as the research objects,according to the status of the infections after catheterization,those patients were divided into the infection group and the non-infection group.The relationship between the exposure factors and the infections were analyzed,the measures for prevention of PICC infections were explored in accordance with the result in combination with clinical practice.RESULTS The OR value of the patients′ gender and the location of the venous catheterization were less than 2.00,the differences were statistically significant;the OR value of the patients with 60 years of age or older,underlying diseases such as diabetes,catheterization more than 5 years,catheterization duration more than 180 days,and the liquid of venous infusion were 2.78,2.57,2.09,2.45,and 2.77,the differences were statistically significant(P<0.05);the proportions of the patients with 60 years of age or older,diabetes,catheterization more than 5 years,intravenous infusion of total parenteral nutrition,the catheterization duration more than 180 days were 23.18%,11.72%,12.97%,27.80%,and 9.50%,respectively.CONCLUSION The PICC infections can serious affect the patients′ rehabilitation and may cause serious consequence;the medical staff should develop strict treatment and nursing program so as to decrease the infection rate and ensure the patients the good therapeutic effect.