肠外营养患者中心静脉导管相关血行性感染的临床危险因素研究

Clinical risk factors for central venous catheter-related bloodstream infections in parenteral nutrition patients

目的探讨导致肠外营养患者发生中心静脉导管相关血行性感染的临床危险因素,为肠外营养患者临床预防中心静脉导管相关血行性感染的实践提供参考依据。方法选取2013年12月-2014年12月医院收治的经中心静脉导管进行肠外营养治疗的患者210例为研究对象,针对患者发生中心静脉导管相关血行性感染的临床危险因素和细菌培养结果进行统计分析。结果 210例肠外营养患者中,发生中心静脉导管相关血行性感染患者34例,感染率为16.19%;34例患者共培养出病原菌40株,其中革兰阳性菌19株,占47.50%,革兰阴性菌14株,占35.00%,真菌7株,占17.50%;患者发生中心静脉导管相关血行性感染的危险因素有导管留置时间、肠外营养时间、拔管时最高体温和多发创伤。结论导致肠外营养患者发生中心静脉导管相关血行性感染的临床危险因素有导管留置时间、肠外营养时间、拔管时最高体温和多发创伤,临床实践过程中应针对上述危险因素采用有针对性的预防措施。

OBJECTIVE To explore the clinical risk factors for central venous catheter-related bloodstream infections in parenteral nutrition patients so as to provide guidance for clinical prevention of the central venous catheter-relat- ed bloodstream infection. METHODS A total of 210 patients who were treated with parenteral nutrition via central venous catheter from Dec 2013 to Dee 2014 were recruited as the study objects. The clinical risk factors for the cen- tral venous catheter-related bloodstream infections and result of bacterial culture were statistically analyzed. RESULTS Of the 210 parenteral nutrition patients, 34 had the central venous catheter-related bloodstream infec- tions, with the infection rate 16.19 %. Totally 40 strains of pathogens were isolated from the 34 patients, including 19 （47.50%） strains of gram-positive bacteria, 14 （35.00%） strains of gram-negative bacteria, and 7 （17.50%） strains of fungi. The risk factors for the central venous catheter-related bloodstream infections in the patients in- cluded the catheter indwelling time, parenteral nutrition time, and highest body temperature at extubation, and multiple trauma. CONCLUSION The clinical risk factors for the central venous catheter-related bloodstream infec- tions in the parenteral nutrition patients include the catheter indwelling time, parenteral nutrition time, and high- est body temperature at extubation, and multiple trauma. It is necessary to take targeted prevention measures a- gainst the above risk factors during the clinical practice.