CLB预防极低出生体质量儿中心静脉导管相关感染效果

A CENTRAL LINE BUNDLE IN THE PREVENTION OF CATHETER-RELATED INFECTION IN VERY LOW BIRTH WEIGHT INFANTS

目的探讨应用中心静脉导管集束(CLB)及检查表,预防极低出生体质量儿经外周静脉置入中心静脉导管(PICC)导管相关性感染(CRI)的有效性。方法选取青岛市某三级甲等医院2012年11月—2013年6月应用CLB及检查表的57例极低出生体质量儿作为观察组,2011年11月—2012年6月未应用CLB及检查表的53例极低出生体质量儿作为对照组,比较两组CRI发生率。结果观察组CRI发生率为2.199/1 000导管日,对照组为10.008/1 000导管日,两组差异有显著性(χ2=8.522,P<0.05)。其中,导管相关性血流感染率观察组为0,对照组为3.079/1 000导管日;定植菌感染率观察组为2.199/1 000导管日,对照组为6.928/1 000导管日,两组比较差异有显著性(χ2=4.082,P<0.05)。导管留置时间观察组长于对照组,差异有显著性意义(t′=3.326,P<0.05)。结论 CLB及检查表能有效预防极低出生体质量儿CRI的发生,同时可以延长导管留置时间。

Objective To assess the validity of a central line bundle （CLB） and the checklist in prevention of catheter-re- lated infections （CRI） caused by peripherally inserted central catheter （PICC） in very low birth weight children （VLBWC）. Methods From November 2012 to June 2013, 57 VLBWC received CLB and the checklist in a hospital of Qingdao were selected and served as observation group, and 53 who did not receive CLB and the Checklist, during November 2011--June 2012, were served as control group. The CRI between the two groups was compared. Results The CRI rate in the observation group was 2.199/1 000 catheter days, that in the control group was 10.008/1 000 catheter days （X^2 =8.522,P〈0.05）, the difference being significant. In which, the rate of catheter-related bloodstream infections was 0 in the observation group, and that in the control group was 3.079/1 000 catheter days, the infection rate of colonizers was 2.199/1 000 catheter days in the observation group, and 6.928/1 000 catheter days in the control （X^2 =4.082 ,P〈0.05）. The keeping time of catheter in the observation group was longer than that in the control （t＇=3.326,P〈0.05）. Conclusion A central line bundle and the Checklist can effectively prevent cathe- ter-related infections in very low birth weight children and extend the time of the indwelling catheter.