血液净化中心静脉导管相关性菌血症的临床分析

Clinical Analysis of central venous catheter-related bacteremia in patients with blood purification

目的了解血液净化患者导管相关性菌血症的发生率和影响因素。方法回顾性分析326例次中心静脉置管行血液净化治疗患者的年龄、性别、置管时间、置管方式和菌血症的关系及分析致病菌的构成比。结果 326例次中心静脉置管中,导管相关性菌血症的感染率是9.5%,按导管日计算为3.22例次/1000导管日;股静脉导管感染率6.74例次/1000导管日明显高于颈内静脉导管(2.83)及长期导管(2.19)(P<0.05),留置时间长短与感染的关系有统计学意义(P<0.05);金黄色葡萄球菌(38.7%)是最常见致病菌,其次为屎肠球菌、表皮葡萄球菌、绿脓杆菌等。结论中心静脉导管留置时间的长短和导管相关性菌血症的发生相关。

Objective To investigate the incidence and factors of central venous catheter-related bacteremia in patients with blood purification.Methods We retrospectively evaluated the correlation of bacteremia to age,sex,the way of catheterization and the indwelling time of the catheter in 326 episodes of central venous catheterization,and studied the variety of pathogenic bacteria causing bacteremia.Results The incidence of catheter-related bacteremia accounted for 9.5%,and 3.32 episodes per 1,000 catheter per day.The infection rate of thigh venous catheter(6.74 episodes per 1,000 catheter per day) was higher than neck inside venous catheter(2.83) and long-term catheter (2.19)(P<0.05),The infection rate was signifi- cantly related to the indwelling time of the catheter(P<0.05).The frequently isolated pathogenic bacteria included staphylococcus aureus(38.7%),and the second is enterococcus,staphylococcus epidermidis and pseudomona aeruginosa Conclusion The occurrence of catheter-related bacteremia was related to the indwelling time of the catheter.