集束干预策略在降低神经外科中心静脉导管相关性血流感染率中的效果观察

CVC central line bundle for reducing catheter-related blood stream infection of neurosurgery

目的探讨集束干预策略在降低神经外科中心静脉导管相关性血流感染（catheter related blood stream infection, CRBSI）中的效果。方法把实施集束干预策略前f2013年7—12月）留置中心静脉导管62例患者设为对照组，把实施集束干预策略后（2014年1—6月）留置中心静脉导管70例患者设为观察组。比较两组患者导管置管情况及CRBSI发生率。结果观察组锁骨下静脉置管率从8．06％上升至31．43％，明显多于对照组，股静脉置管率从25．81％下降至4．29％，明显少于对照组，PICC置管率从1．61％上升至14．29％，差异具有统计学意义（均P〈0．01）；CRBSI发生率从7．22％。下降至1．54％。，差异具有统计学意义（P〈0．05）。结论集束干预策略可有效减少神经外科中心静脉置管患者CRBSI的发生。

Objective To study the effect of central venous catheter （CVC） central line bundle for reducing catheter-related blood stream infection of neurosurgery. Method Sixty-two patients undergoing CVC from July to December 2013 before applying central line bundle were set as a control group and another 70 unertaking CVC from January to June 2014 after using central line bundle an observation group. The catheteration situation and the incidence of CRBSI were compared between these groups. Results The catheteration rate of subclavian vein increased from 8.06% to 31.43% in the observation group and was significantly more than that in the control group; that of femoral vein decreased from 25.81% to 4.29% in the observation group and was significantly less than that in the control group; and the PICC increased from 1.61% to 14.29% in the observation group and was significantly more than that in the control group （P〈0.01）. The incidence of CRBSI decreased from 7.22%0 to 1.54%o （P〈0.05）. Conclusion CVC central line bundle may effectively reduce the incidence of CRBSI.