连续性血液滤过患者中心静脉导管感染因素分析及对策

Analysis and strategy of infection factors of central venous catheter in continuous veno-venous hemofiltration patients

目的分析连续性血液滤过患者中心静脉留置导管感染发病率、相关因素以及预防措施。方法回顾性分析2006年2月-2012年4月130例行连续性血液滤过患者中心静脉导管相关性感染原因,制定预防措施。结果 130例患者中锁骨下静脉置管109例、颈内静脉置管15例、股静脉置管6例;其发生感染导管相关感染21例,感染率16.15%,其中置管出口部位感染12例占9.23%,导管相关血流感染9例占6.92%;给予积极处理后均好转。结论导管留置时间过长、无菌操作不严格、置管部位护理不当以及患者基础疾病是导致中心静脉导管相关性感染的重要原因;加强医护人员的培训、缩短导管留置时间、加强导管护理、及时对症处理是减少导管相关性感染的关键。

OBJECTIVE To analyze the incidence, related factors and prevention measures of indwelling central venous catheter related infection in the continuous veno-venous hemofiltration patients. METHODS A retrospective analysis from Feb. 2006 to Apr. 2012 was conducted on 130 patients with continuous veno-venous hemofiltration in order to analyze the causes of central venous catheter related infection. RESULTS Among 130 patients received the central venous catheterization, 109 cases received the subclavian vein catheter, 15 cases received jugular vein catheter, 6 cases received femoral vein catheter; the catheter-related infections occurred in 21 caese with the infection rate of 16.15% ; the infection of catheter exit site were found in 12 cases, accounting for 9.23% ,catheter related bloodstream infection were fqund in 9 eases, accounting for 6.92 %. CONCLUSION The main reasons of causing central venous catheter related infection are long indwelling of catheter, no strict sterile operation, improp-er care of catheterization site and underlying diseases of patients. Improving training of medical staff, shorter catheter indwelling time, strengthening catheter care and taking timely treatment are the key points to reduce the infection.