集束化护理在导管相关性血流感染中的应用

Application of cluster care in the catheter-related bloodstream infections

目的：探讨集束化护理在预防中心静脉导管相关性血流感染中的应用价值。方法从 ICU 收治的留置中心静脉导管的患者中选取200例为研究对象，采用随机数字表法分为研究组和对照组，每组各100例，对照组患者行常规护理，研究组患者行集束化护理。比较两组置管部位、置管时间、感染发生率。结果研究组中颈内静脉置管、锁下静脉置管、股静脉置管分别为82．00％（82／100）、14．00％（14／100）、4．00％（4／100），与对照组的79．00％（79／100）、15．00％（15／100）、6．00％（6／100）比较，差异均无统计学意义（均 P ＞0．05）；研究组置管时间为（10．36±4．67）d，与对照组的（11．28±4．58）d 相当，组间差异无统计学意义（χ2＝1．406，P ＞0．05）。研究组导管相关性血流感染发生率为1．00％（1／100），明显低于对照组的9．00％（9／100）（χ2＝6．736，P ＝0．009）。结论集束化护理在留置中心静脉导管患者中的应用，较常规护理模式而言，可以显著降低中心静脉导管相关性血流感染发生率，是一种有效的护理干预模式。

Objective To explore the application value of cluster nursing care in preventing central venous catheter -related bloodstream infections.Methods 200 patients with indwelling central venous catheter in ICU were selected as the research subjects.They were randomly divided into study group and control group by digital table, 100 cases in each group.The patients in the control group received routine nursing.The patients in the study group was given cluster based nursing.The catheter site,catheterization time,infection rate were compared between two groups.Results In the study group,the rates of internal jugular vein set pipe and lock venous catheter and femoral vein set tube were 82.00%（82 /100）,14.00%（14 /100）,4.00%（4 /100）,which in the control group were 79.00%（79 /100）,15.00%（15 /100）,6.00%（6 /100）,there were no statistically significant differences（P 〉0.05）.The set tube time of the study group was （10.36 ±4.67）d,which of the control group was （11.28 ±4.58）d,the difference was not statistically significant（χ2 =1.406,P 〉0.05）.The catheter -related bloodstream infection rate of the study group was 1.00%（1 /100）,which was significantly lower than 9.00%（9 /100）of the control group （χ2 =6.736, P =0.009）.Conclusion Compared with conventional nursing mode,cluster of nursing in patients with indwelling central venous catheter can significantly reduce the incidence of central venous catheter related blood stream infections,it is an effective nursing intervention mode.