中心静脉插管相关性感染

Infection complications of central vein catheterisation

目的:探讨与中心静脉插管感染发生相关的主要因素。 方法与结果:回顾分析1994 年1 月～1998 年12月间外科ICU(SICU)中心静脉插管相关性感染(CRS)的发生情况,共插管475 根,11 根(2.32% )伴有明确CRS,多发生于插管后第2～7天,而不同插管位置CRS发生无差异。检出主要致病菌有表皮葡萄球菌、真菌和不动杆菌。 结论:通过中心静脉导管旁路或三通输液、给药是造成CRS发生的主要因素,存在其他感染灶、胸腹壁的清洁程度和自身免疫状况亦与CRS发生有着密切关系。无论何种致病菌导致的CRS,均应先拔除导管。

Objectives:To evaluate the mostly factors of the incidence of catheter related sepsis(CRS). Methods and results:Reviewith the incidence of CRS in surgical intensive care unit(SICU) form Jan 1994 to Dec 1998,11 central venous catheters(CVCs) of 475 CVCs (2.32%) had definite CRS.Those septic events mostly occurred in about 2~7 days after placement.Different access had n o differences with the incidence of CRS.Staphylococcus epidermidis,fungus and Acinetobacters were the major pathogens. Conclusion:Infusion through the side prots or three way stopcocks of CVCs played the improtant role in the incidence of CRS.Surgical infections coexisted ,contamination of chest and abdominal wall,and immunosuppression status had a close affinity to CRS.Catheters with CRS should be removed regardless of any pathogens and if CRS is caused by fungus the antifongal therapy should be used.