深静脉置管区导管感染的相关因素分析

目的 分析深静脉置管区导管感染的相关因素,预防深静脉置管区导管感染.方法 选择2009年3月至2011年12月在医院急诊ICU给予深静脉置管的患者349例为研究对象,深静脉置管时间＜21 d的患者186例,＞21d患者共163例；163例置管时间＞21 d的患者中,按入院单、双号随机分为导管头暴露组86例,深静脉导管(24 h)灭菌纱布保护组77例,每天更换灭菌纱布；置管时间＜21 d的患者186例按入院单双号分为暴露组97例,灭菌纱布保护组89例；两组导管暴露组共183例,两组纱布保护组166例；检查导管穿刺口、管周皮肤、拔管时血培养以及拔管时管头情况.结果 置管时间＞21 d患者的感染率为9.20％,明显高于置管时间＜21 d的患者3.22％；股静脉置管的患者发生导管感染的比例为17.86％,明显高于其他部位；导管暴露组的感染率为9.83％,明显高于灭菌纱布保护组1.81％；差异均有统计学意义(P＜0.05).结论 深静脉置管时间长、置管位置以及是否处理导管等均是发生深静脉置管区导管感染的相关感染因素.

Related factors of infections in location of deep venous catheter

OBJECTIVE To analyze the related factors for the infections in the location of the deep venous catheter.METHODS A total of 349 cases with deep venous catheterization in ICU Division of the hospital emergency room from Mar 2009 to Dec 2011 were chosen as the research objects.There were 186 patients with the duration of deep venous catheterization less than 21 days and 163 patients with the duration of deep venous catheterization more than 21 days;totally 163 patients with the duration of deep venous catheterization more than 21 days were randomly divided into 86 cases of the catheter tip exposed group and 77 cases of deep vein catheter(24 hours a day) sterile gauze protection group according to the admission single and double,and the 186 patients were divided into the exposure group(97 cases) and the sterilized gauze protection group(89 cases).There were totally 183 cases by adding the catheter exposure cases and 166 cases by adding the gauze protection cases.The blood culture of the catheter puncture site and tube skin around the tube head as the extubation performed as well as the tube head was checked.RESULTS The catheter infection rate of the patients with the catheterization duration more than 21 days was 9.20%,significantly higher than 3.22% of the patients with catheterization duration less than 21 days;the infection rate of the patients with the femoral vein catheterization was 17.86%,significantly higher than that of other site catheterization;the infection rate of the catheter exposure group was 9.83%,significantly higher than 1.81% of the sterilized gauze protection group,the differences were statistically significant(P<0.05).CONCLUSION The extended duration of deep venous catheterization,catheter location,and the treatment of catheter are the related factors for the infections in the location of deep venous catheter.