综合ICU目标性监测的比较分析

The Comparison and Analysis on Targeted Monitoring on Comprehensive ICU

目的通过分析综合重症监护病房(ICU)医院感染控制方面存在的问题及改进的重点,进而为提出更好的干预控制措施提供参考。方法对综合ICU 2010—2011年入住患者的医院感染发生情况,呼吸机、中心静脉置管及留置尿管的使用率及相关感染率进行统计分析。结果 2011年较2010年,医院感染率下降显著,感染例次率下降不显著;中心静脉导管使用率增加不显著,而留置导尿管及呼吸机使用率下降显著;同时,对应的导管相关血流感染(CRBSI)及呼吸机相关肺炎(VAP)感染率也呈下降趋势,仅导尿管相关尿路感染(CAUTI)感染率略有增加;医院感染(HAI)患者发生感染时的插管日数比较差别不显著。结论综合ICU导管相关感染率的下降趋势与医院增加的干预及控制措施有关,但仍需进一步加强导管相关性感染的危险因素控制,保证其持续下降。

Objective：To analyze the problems and the reform focus in the controlling of nosocomial infection in the comprehensive ICU. Method： The authors make statistical analysis on nosocomial infection, the applying rate and the related infectious rate of breathing machine, central venous indwelling catheter and indwelling urinary catheter related with hospitalized patients in the comprehensive ICU from 2010 to 2011. Result： Nosocomial infection in 2011 is significantly lower than that of 2010 while the rate of infectious cases and times fails to reduce obviously. There isnt obvious growth in the usage of central venous catheter while the using rate of indwelling urinary catheter and breathing machine decreases re- markably. Simultaneously, the rates of the corresponding catheter-related blood stream infection （CRBSI） and ventilator- associated pneumonia （VAP） are in the decreasing trend but catheter associated urinary tract infection （CAUTI） infection increases. The difference in the number of the days of HAI patients＇intubation tube is not striking. Conclusion：The decli- ning trend of the infection related with catheter in comprehensive ICU is relevant with the increased interventions and the controlling measures. The controlling over the dangerous factors for the infection related with catheter should be further strengthened so as to ensure the continuing decrease.