NICU患者中心静脉导管相关性感染的危险因素分析

Risk factors for central venous catheter-related infections in NICU

目的控制神经重症监护病房(NICU)患者中心静脉导管相关性感染的危险因素。方法收集自2007-2011年入住NICU并进行中心静脉导管置管的患者资料,按照是否发生中心静脉导管感染进行分组,使用logistic回归分析方法明确NICU患者发生中心静脉导管相关性感染的危险因素。结果自2007-2011年NICU进行中心静脉置管778例次,发生中心静脉导管感染175例次,发生率为22.4%,发生中心静脉导管相关性感染的平均时间9.1d;送检导管中病原菌检出阳性率为40.2%,导管血送检病原菌检出率为42.5%;logistic回归分析结果显示,糖尿病史及置入三腔导管进入最终的回归模型,OR值分别为3.777、9.094和7.342。结论 NICU患者中心静脉导管相关性感染的发病率高,中重度昏迷、糖尿病史及置入三腔导管是发生中心导管相关性感染的危险因素,建议临床对该类患者进行重点防护。

OBJECTIVE To identify the risk factors of central venous catheter-related infections in neurosurgery intensive care unit（NICU）.METHODS We recruited the patients with central venous catheter-related infections in NICU from 2007 to 2011.The patients were divided according to the status of the infections,the logistic regression analysis method was employed to define the risk factors for the central venous catheter-related infections.RESULTS Of 778 case-time of patients who underwent central venous catheterization during 2007-2011,the central venous catheter-related infections occurred in 175 case-times of patients with the incidence rate of 22.4%,the median time to onset of central venous catheters related infections was 9.1 days.The positive rate of the pathogens isolated from submitted catheters was 40.2%,42.5% of the submitted catheter blood.Logistic regression analysis showed that three factors including the history of diabetes mellitus and use of three-cavity catheter entered the final regression model,and the OR values were 3.777,9.094,and 7.342,respectively.CONCLUSION The incidence of the central venous catheter-related infections is high in the NICU patients.The moderate and severe coma,history of diabetes mellitus and use of three-cavity catheter are the risk factors for the catheter-related infections.It is suggested that the great attention should be paid to the aspect of infection prevention for the patients at risk of the central venous catheter-related infections.