综合ICU导管相关性感染危险因素分析及预防对策

Analysis of risk factors and strategies for prevention of catheter-related infection in general intensive care unit

目的:探讨并分析综合ICU患者中心静脉导管感染的危险因素及预防对策。方法:选择综合ICU 2009年7月～2010年6月中心静脉置管患者218例,对所有送检的中心静脉导管的培养结果进行回顾性分析。结果:218例样本中细菌培养阳性46例,感染率为21.10%,其中G+球菌占63.04%,真菌占28.26%,G-杆菌占8.70%。与中心静脉导管相关性感染有显著关系的因素有年龄、置管部位、导管留置时间、应用静脉高营养、气管切开应用呼吸机等(P<0.05)。结论:引起综合ICU中心静脉导管感染的病原菌以葡萄球菌为首位,其次为真菌。严格的无菌操作、缩短置管时间和合理使用抗菌药物,对防止综合ICU患者中心静脉导管感染具有重要的临床意义。

Objective： To study the risk factors of central venous catheter-related infection in general ICU and its strategies for prevention.Methods： To retrospectively analyze the results of bacterial culture of samples of 218 cases with central venous catheter indwelling admitted to the general ICU from 2009 to 2010.Result：Of the 218 samples cultured,46 were positive and the general correlated infection rate was 21.1%.Out of the total bacteria,positive cocci accounted for 63.04%,fungus 28.3% and negative bacilli 8.7%.There were several significant factors concerning the infection related to central venous catheter： ages,the position of indwelling and the indwelling time of the catheter,application of parenteral nutrition and tracheotomy.Conclusion： The primary pathogen of central venous catheter-related infection in general ICU is staphylococcus,and the second one is fungus.Asepsis technique during the operation should be strictly handled.Special attention should be paid to the strict nursing care,the indwelling time of the central venous catheter should be shortened.In addition,rational use of antibiotics were significant in the prevention of the infection related to central venous catheter in general ICU.