恶性肿瘤患者导管相关性感染因素分析及护理干预

Factor Analysis and Nursing Intervention on Catheter-related Infections for Patients with Malignant Tumor

目的探讨影响恶性肿瘤患者导管相关性感染(catheter-related infections,CRI)因素及护理干预措施。方法采用回顾性调查的方法,统计CRI发生率;观察并比较CRI组与无CRI组年龄、置管次数、导管位置、导管留置时间及应用化疗、高营养药物的频率、合并症、病情、合用激素者等方面差异并进行2χ检验。结果CRI感染率9.2%;影响CRI发生的主要因素有:年龄≥60岁、多次置管、导管尖端位于SVC-RA交界处、长期留置、多周期化疗、静脉高营养≥15d、存在合并症及应用激素、病情重等。结论深静脉置管术后由于多种因素的影响CRI难以完全避免,可通过严格执行无菌操作规程、严格皮肤消毒、重视导管接头消毒、保持导管通畅、缩短静脉导管留置时间、加强导管护理方法的教育等措施来预防。

Objective： To explore the factors of catheter-related infection （CRI） and correlative nursing intervention. Methods： A retrospective analysis was adopted to observe the CRI incidence, and to compare the effects of age, frequency of catheter inserting, catheter sites, indwelling time, frequency of injecting chemical medicine and high-nutrition fluid, complications, disease status, using hormone drugs, and so on. Chi square test was used. Results： The CRI rate was 9.2%; The factors of CRI included： age≥60 years old, multiple inserting, the pointed end was located the borderline of SVC-RA, indwelling for a long time, multiple periods of chemical treatment, infusing high-nutrition fluid for more than 15 days, existing complications, using hormone drugs and serious disease,and so on. Conclusion： It is inevitable for CRI occurrence after catheter inserting in deep vein. It can be reduced through implementing aseptic technique and strictly skin disinfection, paying attention to the joint disinfection, keeping catheter expedite, shortening the indwelling time, and enhancing education for catheter nursing.