神经外科患者中心静脉导管相关性感染因素分析

Analysis of central venous catheter related infection factors in the neurosurgery patients

目的探讨神经外科中心静脉置管患者发生导管相关性感染因素及预防治疗对策，减少导管相关性感染的发生率。方法回顾性分析医院2011年1月～2012年12月109例神经外科中心静脉置管患者的临床资料，对16例患者发生导管相关性感染的原因进行分析并制定护理对策。结果16例发生导管相关感染的置管患者均及时拔除置管，患者经局部换药及全身抗菌药物积极治疗后均治愈，无死亡病例，治愈时间3～7d。结论神经外科患者中心静脉导管相关性感染与患者因素、导管材质、护士操作不当、导管留置时间长、导管固定及局部穿刺点护理不当等有关；应加强护士的培训，严格无菌操作及规范操作规程，选择抗菌导管、改进导管固定方法，加强局部皮肤护理和临床观察等，是预防神经外科患者中心静脉导管相关性感染的关键。

OBJECTIVE To discuss the catheter related infection factors in neurosurgery patients implanted with central venous catheter and countermeasures of prevention and control, so as to reduce the incidence of catheter related infections. METHODS A retrospective analysis was conducted on the clinical data of neurosurgery patients with central venous catheter in the hospital from Jan. 2011 to Dec. 2012, and the causes of catheter related infections in 16 patients were investigated and analyzed, and nursing countermeasures were made for the infection. RESULTS The catheters in 16 neurosurgery patients with central venous catheter related infections were all withdrawn, all the patients were cured after local dressing and systemic active treatment with antimicrobial agents, no deaths were found, and the cure time was 3 - 7 days. CONCLUSION The central venous catheter related infection in the neurosurgery patients was related with patient factors, catheter material, improper nursing operation, long indwelling time, improper catheter fixation and care of local puncture sites, etc.. Strengthening the nurse training, strict aseptic operation and standard operation procedures, choosing antimicrobial catheters, improving the catheter fixation method, strengthening local skin care and clinical observation are the key points to prevent central venous catheter related infections in neurosurgery patients.