肝胆外科颈内静脉留置中心静脉导管感染现况调查分析

The status investigation and analysis of indwelling central venous catheter infection with internal jugular vein

目的探讨颈内留置中心静脉导管(CVC)感染的相关因素,并制订预防对策。方法选择该院肝胆外科颈内静脉留置CVC患者564例,采用杏林医院感染实时监控系统提取患者的相关数据,采用SPSS15.0进行统计分析。结果颈内静脉留置CVC患者感染率为4.07%。革兰阴性菌感染占43.5%,革兰阳性菌感染占34.8%,真菌占21.7%,感染患者中多重耐药菌感染占52.1%。导管留置14d以上感染率为8.5%,14d以下感染率为2.1%,感染患者多为晚期肿瘤和重症胰腺炎患者。不同导管接头,感染率差异有统计学意义(P<0.05)。结论颈内静脉留置CVC感染不容忽视,感染的发生与患者病情、置管时间、接头装置等紧密相关。

Objective To explore the related infection factors of the internal jugular vein indwelling central venous catheter, and make prevention countermeasures according to the infection factors of central venous catheter infections. Methods A total of 564 patients admitted in liver and gallbladder surgical ward with external jugular vein indwelling central venous catheter were selected,extract the relevant hospital infection data in patients by the XingLin hospital infection real-time monitoring system, and SPSS15.0 statistical analysis was conducted. Results The infection rate of 564 cases of patients was 4.07%. The rate of gram-negative bacteria infection was 43.5 %, the gram positive bacteria infection accounted for 34.8 %, fungi accounted for 21.7 % ,including multiple drug-resistant bacteria infection accounted for 52.1%. Catheter indwelling 14 d or more infection rate was 8.5 %, 14 d following infection rate was 2. 1%, and infected patients for more advanced cancer and patients with severe acute pancreatitis. Pipe joint respectively with heparin cap and needle positive pressure infusion joint connections,infection rate was statistically different （P〈0.05）. Conclusion The infection of internal jugular vein indwelling central venous catheter should not be ignored,and the occurrence of catheter-related infection of patients is closely related to state of an illness, the time of catheter insertion, and the joint device and so on.