摘要
目的探讨重症监护病房老年患者并发导管相关性感染的危险因素。方法对该院重症监护病房77例静脉导管留置老年患者的临床资料进行回顾性分析,对其影响因素行多因素COX逐步回归分析,应用Kaplan-Meier法计算累计并发感染率,采用log-rank检验方法进行检验。结果本研究组1、3、5、7、9 d累计感染率为1.30%、2.60%、12.99%、16.88%、23.38%,中位并发感染时间为5.5 d。77例患者中,确诊为导管相关性感染的患者为23例,占29.87%,检出的病原菌革兰阳性球菌占65.22%,革兰阴性杆菌占30.43%,真菌占4.35%。单因素COX回归模型分析显示对并发感染有影响的因素有:导管留置部位、静脉高营养药物的应用、血氧饱和度、血清白蛋白、β2微球蛋白、D二聚体,将有意义的变量应用COX逐步回归分析,显示导管留置部位、静脉高营养药物的应用、血清白蛋白含量,D二聚体含量为并发导管相关性感染的独立危险因素,且这些因素与导管留置时间密切相关。结论导管留置部位、静脉高营养药物的应用、血清白蛋白含量、D二聚体含量是与留置时间相关的导管相关性感染的独立危险因素,控制上述危险因素对临床采取措施预防导管相关性感染有较高的实际意义。
Objective To study the risk factors of venous catheter-related infections in the elderly patients in intensive care unit （ICU）. Methods The clinical data of 77 elderly patients with venous catheter indwelling in ICU were retrospectively analyzed with stepwise multivariate COX regression analysis, and the accumulated concurrent infection rate was calculated by the Kaplan-Meier method and log-rank test methods. Results The cumulative infection rate of the study group in 1,3,5,7,9 d was 1.30%, 2. 60%, 12.99%, 16. 88%, 23.38%, and the median time with concurrent in- fection was 5.5 d. Twenty-three out of 77 cases were diagnosed as catheter-related infections, accounting for 29. 87%. Out of the 23 cases, 65.22% of them were G＋ cocci, 30. 43% were G- bacilli, 4. 35% were fungi. The following factors, such as catheter site, intravenous nutrition drug application, serum albumin concentration, content of D-dimer were independent risk factors for catheter-related infections. The above factors were closely related with the catheters indwelling time. Con- dusions The factors which are associated with indwelling time such as catheter site, intravenous nutrition drug application, serum albumin concentration, D-dimer levels are independent risk factors for catheter-related infections. It＇s important to take some measures to control the above factors to prevent catheter-related infections.
出处
《实用老年医学》
CAS
2014年第8期655-657,共3页
Practical Geriatrics
