中心静脉导管留置时间与血行性感染的相关性分析

The Correlation Analysis of Central Venous Catheter Retention Time and Catheter Related Bloodstream Infection

目的：探讨中心静脉导管（CVC）留置时间与导管相关性血行感染（CRBSI）的相关性。方法：收集2010年2月-2014年2月本院1086例使用过CVC的患者资料，分析CVC留置1-7 d、7-14 d、14-21 d、21-28 d和≥28 d几个不同时间段CRBSI的发病率，并对CRBSI患者不同年龄段、性别、CVC留置时间和CVC置管处皮肤细菌数做统计学分析。结果：1086例使用过CVC的患者中共发生了352例CRBSI，CVC留置1-7 d、7-14 d、14-21 d、21-28 d和≥28 d CRBSI的发病数分别为65例（5.98%）、69例（8.84%）、143例（13.17%）、198例（18.23%）和352例（32.41%）。CVC留置≤3 d比3-7 d CRBSI发病率有显著性升高，差异有统计学意义（P〈0.01），≥28 d比3-28 d CRBSI发病率也有显著性升高，差异有统计学意义（P=0.04）。另外患者年龄≥60岁、CVC经皮穿刺置管和CVC置管处皮肤细菌数≥100 CFU/10 cm2也是导致CRBSI的重要因素。结论：CVC留置的前3天和后28天是CRBSI发生的高峰时间，CRBSI的发生与患者年龄大和置管处皮肤细菌数多有关。

Objective： To investigate the correlation of central venous catheter （CVC） retention time and catheter related b1oodstream infection （CRBSI）.Method： A total of 1086 patients who were treated with CVC in our hospital were selected from February 2010 to February 2014,the CRBSI incidence of 1086 patients in different time periods of indwelling CVC 1-7 d, 7-14 d, 14-21 d, 21-28 d and ≥28 d were analysed,the CRBSI of different ages,gender, CVC retention time and the number of skin bacteria of indwelling CVC were statistical analysed.Result： There were 352 cases of CRBSI in 1086 patients who used CVC, CRBSI incidence were respectively 65 cases （5.98%）, 69 cases （8.84%）, 143 cases （13.17%）, 198 cases （18.23%） and 352 cases （32.41%） in indwelling CVC 1-7 d, 7-14 d, 14-21 d, 21-28 d and≥28 d.The CRBSI incidence of indwelling CVC ≤3 days has increased significantly than 3 to 7 days,the difference was statistically significant（P〈0.01）.The CRBSI incidence of indwelling CVC≥28 days has increased significantly than 3 to 28 days,the difference was statistically significant（P=0.04）.The age of patients ≥60 years, and the skin bacteria of indwelling CVC ≥100 CFU/10 cm2 were also the important factor of CRBSI.Conclusion：Indwelling CVC ≤3 days and≥28 days are the peak time of CRBSI,the patients’ age and skin bacteria of indwelling CVC are also the important factor of CRBSI.