中心静脉导管集束干预策略降低ICU导管相关性血流感染的应用研究

Effect of CLB measures on reducing central venous catheter-related bloodstream infections in ICUs

目的探讨应用基于循证的中心静脉导管集束干预策略(CLB),在降低ICU中心静脉导管相关性血流感染(CRBSI)发生率的效果,为进一步降低CRBSI提供理论及实践依据。方法将ICU 995例中心静脉置管患者作为研究对象,第1阶段2011年1-12月411例患者,2777个导管日为对照组,进行常规目标性监测;第2阶段2012年1-12月584例患者,3920个导管日为观察组,通过施行CLB措施预防CRBSI,比较两组CRBSI发生率,观察该集束干预策略在ICU中的应用效果。结果观察组CRBSI发生15例,发生率为3.83‰,对照组发生21例,发生率为7.56‰,经卡方检验,差异有统计学意义(P<0.05);采取CLB措施后CRBSI发生率呈逐步下降趋势。结论 ICU施行CLB能有效降低危重病患者CRBSI的发生率。

OBJECTIVE To study the effect of evidence-based CLB on reducing the incidence of central venous catheter-related bloodstream infection （CRBSI） in ICUs and provide theoretical and practical evidence for further decreasing the incidence of CRBSI. METHODS This study involved 995 patients with CVCs. At the first stage in 2011, 411 patients and 2777 catheter-days were observed by routine targeted surveillance as the control group. At the second stage in 2012, the CLB was carried out, 584 patients and 3920 catheter--days were involved, which were set as the experimental group. The incidence of the CRBSI was compared between two stages so as to evalu- ate the effect of CLB in ICUs. RESULTS The incidence of CRBSI of the experimental group was 3. 83‰ （15 cases）, the control group 7.56‰ （21 cases ）, and the chi-square test showed that the difference between the two groups was statistically significant（P〈0.05）. From the trend chart, the incidence of CRBSI went down gradually since CLB was carried out. CONCLUSION To carry out CLB in the ICUs can effectively decrease the incidence of CRBSI in critically ill patients.