中心静脉置管患者导管相关性血行感染的多因素分析

Analysis of factors relevant to catheter-related bloodstream infection

目的:探讨中心静脉置管患者导管相关性血行感染的相关因素,为制定导管相关血行感染预防措施提供依据。方法:回顾性分析2003年7月～2008年1月309例行中心静脉置管治疗患者的临床护理资料,对导管相关血行感染的相关因素进行Logistic多元回归分析。结果:309例患者中,导管相关血行感染73例,平均发生率8.1/1 000留置导管日,死亡8例,占导管相关血行感染例数的11.0%(8/73);单因素和多因素分析显示,预防教育、置管部位与置管时间、手部卫生和无菌屏障、敷料种类及消毒剂类型等是导管相关血行感染的独立相关因素。结论:导管相关血行感染的预防需制定系统的技术操作和评价规范。

Objective： To explore factors related to catheter related bloodstream infection, and provide the evidence for prevention of catheter related bloodstream infection. Methods： A retrospective review of 309 patients, who underwent central venous catheters from Jul. 2003 to Jan. 2008, had been performed. Factors related to catheter related bloodstream infection were analyzed by Logistic regression method. Results： There were 73 cases with catheter-related bloodstream infection in 309 cases. The average incidence was 8.1/1 000 catheter days, 8 of them died （11.0%, 8/73）. Univariateand multivariate analysis showed that prevention educational, anatomic site of insertion, time of catheterization, hand hygiene, aseptic precautions, category of antiseptics and wrappers were independent factors for predicting the catheter-related bloodstream infection （All P〈0.05）. Conclusions： It is necessary to establish rules for operation process and evaluation in prevention of catheter related bloodstream infection.