极低出生体重儿外周静脉导入中心静脉导管与细菌感染的相关性分析

THE RELATIONSHIP BETWEEN PERCUTANEOUS CENTRAL VENOUS CATHETERS IN VERY LOW BIRTH WEIGHT INFANTS AND BACTERIA INFECTION

为探讨极低出生体重儿（VLBW）外用静脉导入中心静脉导管（PCVC）与细菌感染的相关性,对43倒置入中心静脉导管的VLBW和75例经外周静脉穿刺的VLBW,进行回顾性分析。结果显示:8例VLBW发生1次或1次以上细菌感染,感染率为18.6％（8/43）。其中,6例感染病例成功治疗后保留导管,2例治疗后无效拔管。对相关细菌感染的高危因素进行综合分析,并应用Logistic回归分析法得出PCVC应用不是细菌感染的独立高危因素（比值比和95％可信区间分别为0.5,0.21～2.72）,机械通气时间和静脉输脂肪乳时间（比值比和95％见可信区间分别为2.2,1.43～7.96和4.7,2.98～9.86）为细菌感染独立高危因素。因此,认为PCVC作为长期提供静脉营养的基本途径,可以在感染的VLBW继续保留导管,延长PCVC的使用时间。

To investiagte the relationship between percutaneous central venous catheters in very low birth weight infants and bacteria infection, a retrospective study was carried out comparing 43 VLBW with percutaneous central venous catheters with 75 VLBW managed with peripheral cannulae. Results showed eight infants developed one or more episodes of bacteria infection, incidence of infection was 18.6% (8/43), 6 cases of infection were sucessfully treated with reserving catheters, and 2 cases were removed their catheter. Logistic regression analysis was performed to examine risk factors for bacteraemia, PCVC was not an independent risk factor (odds ratio 0.5, 95% confidence limits 0.21 ~ 2.72) , The duration of ventilation and intravenous lipids were both significant risks for infaction ( odds ratios and 95% . confidence lim-its2.2, 1.43 ~ 1.96 and 4.7, 2.98 ~ 9.86 respectively ) . Therefore, PCVC can act as the primary route for prolonged administration of total parenteral nutrition, catheters may be retained VLBW even they are infected.