血液透析患者中心静脉置管感染预防

Prevention analysis of central venous catheter infection in hemodialysis

目的研究探讨血液透析患者在进行中心静脉置管以后的护理措施和预防措施,为降低血液透析患者中心静脉置管感染率提供理论指导。方法调查2012年2月-2013年5月在医院治疗的150例血液透析患者临床资料,随机分为试验组和对照组,每组各75例;将感染发生情况根据发病原因、置管部位、留置时间以及导管的通畅程度等因素进行分析对比,数据采用χ2检验。结果 150例血液透析患者发生感染共44例,总感染率为29.33%,试验组患者发生感染15例,感染率为20.0%;对照组患者发生感染29例,感染率为38.67%,两组差异有统计学意义(χ2=5.6380,P<0.05)。结论确定导管感染发生原因,加强中心静脉置管的护理以及规范血液透析管理,并且采取有效的防治措施,提高血液透析患者的生存率和生活质量;延长中心静脉置管使用期限的关键就是预防中心静脉置管感染和阻塞。

OBJECTIVE To investigate and discuss nursing strategy for central venous catheterization and preventive measures for hemodialysis patients to provide theoretical guidance for reducing central venous catheter infection rates. METHODS Data of 150 hemodialysis patients admitted in the hospital from Feb. 2012 to May 2013 were investigated. The 150 hemodiatysis patients were randomly divided into two groups, ie, the experimental group and the control group, 75 patients in each group. Factors including causes of infections, catheter sites, retention time and obstruction situation were analyzed and compared, data were processed with χ2 test. RESULTS There were 44 cases of infections in the 150 hemodialysis patients, with the total infection rate of 29.33%, including 15 cases in the experimental group （ the infection rate 20.0%） and 29 in the control group （38.67%）, with significant differences （χ2 = 5. 6380, P〈0.05）. CONCLUSION To determine the causes of catheter infections, strengthen the central venous catheter care, and standardize management of hemodialysis, and to take effective preventive measures can not only extend the service life of central venous catheter, but also improve survival in hemodialysis patients and quality of life. Therefore, prevention of central venous catheter infection and obstruction is the key to extend the service life of central venous catheters.