危重病患者中心静脉导管相关性败血病临床分析

Analysis of central venous catheter-related septicemia in critical patients

目的 探讨危重病患者中心静脉导管败血病 (CRS)的发病机理 ,并提出预防措施。方法 回顾性分析 2 4例 CRS患者的临床资料。结果 15例静脉导管培养为念珠菌 ,9例为细菌。其中置管时间 <2 8d者以细菌为主 (6 / 8) ,>2 8d者以真菌感染为主 (13/ 16 )。结论 置管时间 <2 8d者CRS发病机理以细菌沿皮肤逆行感染为主 ,>2 8d者是在菌群失调基础上 ,真菌定位在导管所致。合理选用抗生素 ,缩短导管留置时间 (<7d) ,重视肠内营养是重要的预防措施。

Objective To investigate the pathogenesis of central venous catheter related septicemia in critical patients and propose the strategies for prevention.Methods 24 cases were reviewed.Results The pathogen were Candida albicans(15 cases) and bacterium(9 cases).Bacteria and fungus were the major pathogens in the group of catheterization within 28 days and over 28 days,respectively.Conclusion It can prevent central venous catheter related septicemia to apply antibiotics rationally,decrease the duration of catheter insertion(<7 days) and pay attention to enteral nutrition.