中心静脉导管相关性感染危险因素logistic回归分析

Logisticregression analysis of risk factors of central venous catheter-related infections

目的探讨重症监护病房(ICU)患者中心静脉导管相关性感染(CRI)的危险因素,为CRI的预防治疗提供科学依据。方法回顾性分析医院ICU 2008年3月-2011年3月共529例留置过中心静脉导管(CVC)的患者,计算感染率,筛选危险因素并用SPSS17.0软件以向前逐步回归法进行非条件logistic分析。结果共有51例患者发生CRI,CRI发生率为9.6%;表皮葡萄球菌、大肠埃希菌分别占19.6%和17.6%,是最常见的病原菌;CRI与导管材料(χ2=10.718,OR=2.722)、导管留置时间(χ2=43.746,OR=7.538)、血清白蛋白(χ2=29.218,OR=4.676)和APACHEⅡ评分(χ2=40.984,OR=12.148)有相关性,差异有统计学意义(P<0.01),与置管部位(χ2=0.497,OR=0.796)和年龄(χ2=0.083,OR=0.911)无关,差异无统计学意义。结论减少导管留置时间、选用抗感染导管、提高血清白蛋白水平可以降低CRI的发生率。

OBJECTIVE To investigate risk factors of central venous catheter-related infections（CRI） in ICU patients in order to provide scientific basis for prevention and treatment.METHODS A total of 529 patients,who had underwent the central venous catheterization in the ICU from Mar 2008 to Mar 20111,were retrospectively analyzed.The infection rate was calculated and the risk factors were screened before the non-conditional logistic regression analysis of the likely risk factors in SPSS17.0 was conducted.RESULTS There were totally 51 patients with CRI with the incidence rate of 9.6%.Staphylococcus epidermidis and Escherichia coli were the major pathogens whose detection rates were 19.6% and 17.6%,respectively.The CRI was related to the material of catheter（χ2=10.718,OR=2.722）,catheter indwelling time（χ2=43.746,OR=7.538）,serum protein level（χ2=29.218,OR=4.676） and APACHEⅡscore（χ2=40.984,OR=12.148）,the difference between the risk factors was statistically significant（P0.01）,and it was not related to the catheterization sites（χ2=0.497,OR=0.796） or the age（χ2=0.083,OR=0.911）,the difference was not statistically significant.CONCLUSION Reducing the catheter indwelling time,using anti-infection catheter and promoting serum protein level can reduce the incidence rate of CRI.