重症监护室患者CRBSI预后的高危因素研究

Prognostic Factors of Central Venous Catheter Related Bloodstream Infections in ICU

目的:探讨重症监护室患者CRBSI预后的危险性因素。方法:回顾性分析2011年1月至2013年1月确诊为CRBSI患者的临床资料,比较与分析存活患者与生存患者的基本情况、导管留置时间,导管拔除时间以及血行感染时的各检查指标,应用多元Logistic回归分析预后的高危因素。结果:死亡组患者平均年龄(75.91±21.31)大于存活组患者平均年龄(56.82±16.21)岁,具统计学差异(χ2=5.298,P<0.05),死亡组感染症状出现至导管拔除时间间隔明显长于存活组(χ2=7.872,P<0.05),存活组与死亡组在在谷草转氨酶、血清白蛋白、乳酸脱氢酶、血清肌酐、尿素氮水平上可见统计学差异(P<0.05),其余检测指标未见统计学差异(P>0.05)。结论:CRBSI患者预后状况与其年龄、凝血功能以及肝肾功能有关,高龄、低蛋白血症以及感染导管推迟拔除是CRBSI患者预后死亡的重要独立性高危因素。

Objective： To investigate risk prognostic factors of central venous catheter related bloodstream infections in intensive care unit（ ICU）. Method： Clinical data of diagnosed CRBSI patients from Jan.2011 to Jan. 2013 were retrospectively analyzed,basic information,catheter indwelling time,catheter removal time and indicators of blood infection were compared and analyzed,prognosis risk factors was analyzed by multivariate Logistic regression. Result： The average age of death group（ 75. 91 ± 21. 31） was greater than that of survival group（ 56.82 ± 16.21）,there was a statistically difference（ = 5.298,P〈0.05）,the onset of symptoms to infected catheter removal interval of death group was significantly longer than survival group（ = 7.872,P〈0.05）,aspartate transaminase,serum albumin,lactate dehydrogenase,serum creatinine,urea nitrogen levels in survival group and death group had statistically difference（ P〈0.05）,and no statistically significant difference in other detection index（ P〉0.05）. Conclusion： Prognosis for CRBSI patients is related to age,coagulation and liver or kidney function,old age,hypoalbuminemia and delayed infection catheter removal are important independent risk factors for prognosis CRBSI patients.