血液透析患者中心静脉导管感染因素分析与对策

Infection Factors in Hemodialysis Patients with Central Venous Catheter-related:Analysis and Countermeasures

目的调查分析血液透析患者中心静脉留置导管感染发病率、相关因素,以采取有效的防控措施和护理对策降低感染发生。方法采用回顾性调查方法,对2005年1-12月血液透析患者中心静脉留置导管感染的原因进行调查分析,制定干预措施,并对2006年1月-2008年12月血液透析患者中心静脉留置导管进行目标性监测。结果 2005年血液透析静脉留置导管54例,发生感染13例,感染率24.07%;2006年血液透析静脉留置导管57例,发生感染8例,感染率14.04%;2007年血液透析静脉留置导管59例,发生感染6例,感染率10.17%;2008年血液透析静脉留置导管66例,发生感染4例,感染率6.06%。结论留置导管时间过长,忽略插管部位的监测和护理,无菌操作不严格等是引起中心静脉导管相关感染的主要原因,加强医院感染的管理,针对性地实施干预可减少中心静脉导管相关感染的发生。

OBJECTIVE To investigate and analyze the infection rate of hemodialysis patients′ indwelling central venous catheter and related factors,then provides effective prevention,control and care measures to reduce infection.METHODS A retrospective survey from Jan to Dec 2005 was conducted to investigate and analyze the cause of infection of hemodialysis patient′s indwelling central venous catheter,then develop interventions,and monitor the targeted hemodialysis patients with indwelling central venous catheter during from Jan 2006 to Dec 2008.RESULTS A total of 13 cases were with nosocomial infection with the infection rate of 24.07% among 54 cases of venous catheter in hemodialysis patients in 2005,and 8 cases out of 57 cases of venous catheter in hemodialysis patients in 2006 occured nosocomial infection with the infection rate of 14.04%;6 cases out of 59 cases of venous catheter in hemodialysis patients in 2007 got nosocomial infection with the infection rate of 10.17%;4 cases out of 66 cases of venous catheter in hemodialysis patients in 2008 were with nosocomial infection with the infection rate of 6.06%.CONCLUSIONS The main reasons of causing central venous catheter related infection（CVR-RI）are indwelling catheter for a long time,ignoring the surveillance and care of the intubation parts and no strict aseptic operation.We should strengthen the management of hospital infection and implement targeted intervention to reduce the CVR-RI.