肿瘤患者中心静脉置管相关性感染研究

A Study on Catheter Related Infection in Cancer Patient Treated with Central Venous Catheterization

目的了解肿瘤患者中心静脉置管相关性感染情况。方法对四川大学华西医院196例肿瘤患者进行前瞻性研究,分析导管相关性感染类型和病原菌类型,以及导管相关性感染与置管部位、性别、年龄、置管时间和骨髓抑制程度的关系。结果 196例患者中发生导管相关性感染16例,感染率8.2%,其中病原菌定植5例、出口部位感染4例、导管相关性血流感染7例。共送检标本244份,其中20份病原菌培养阳性,培养出革兰氏阳性和革兰氏阴性两类共7种病原菌,病原菌以金葡菌、表葡菌、鲍曼不动杆菌和肺炎克雷伯杆菌为主。相关性分析显示,导管相关性感染与置管部位和年龄有关,两者均为独立危险因素。结论应树立预防为主的观念,采取综合措施降低导管相关性感染,如选择合适的置管部位和严格导管植入患者的纳入标准等。

Objective To study the catheter-related infection（CRI） in cancer patients treated with central venous catheterization.Methods A prospective study with 196 cancer patients was conducted to analyze the types of catheter-related infection and pathogen,as well as the relationship between CRI and the following factors： insert location,gender,age,remained time,or bone marrow suppression.Results Of the total 196 cases,16 cases were diagnosed as CRI and the CRI rate was 8.2%.The types of CRI were five cases of pathogen colonization,four cases of insert location infection and seven cases of catheter-related bloodstream infection.Of the total 244 specimens,20 were positive including 7 pathogenic bacteria in either Gram positive or Gram negative types,the dominating pathogens were staphylococcus aureus,staphylococcus epidermidis,acinetobacter baumannii and klebsiella pneumoniae.CRI was related to both insert location and age which were both the independent risk factors.Conclusion The concept of prevention should be set up,and the comprehensive measures should be taken to reduce CRI,such as choosing an appropriate insert location and complying with a strict catheter insert standard.