维持性血液透析患者带Cuff的中心静脉导管感染原因及预防

Infection Cause and Prevention Measures of Central Venous Catheter with Cuff of Patients with Maintenance Hemodialysis

目的探究维持性血液透析患者带Cuff的中心静脉导管感染原因与预防方法。方法方便选取该院2013年4月—2016年4月收治的150例维持性血液透析患者的临床资料进行回顾性分析,对患者带Cuff的中心静脉导管感染率、病原菌分布以及相关感染因素进行分析。结果出现感染的有57例患者,感染率为38.00%;病原菌检查38株,革兰阴性菌23株,占60.53%,革兰阳性球菌8株,占21.05%,真菌7株,占18.42%;年龄60岁以下的患者、置管穿刺次数不足3次的感染率分别为28.96%和17.54%,明显比60岁以上老龄患者、穿刺超过3次的感染率(45.68%和82.46%)更低,差异有统计学意义(P<0.05);有糖尿病史的患者其感染率(53.33%)明显比无糖尿病史的患者(31.43%)更高,差异有统计学意义(P<0.05)。结论年龄60岁以上、置管穿刺次数较多,有糖尿病史是维持性血液透析患者带Cuff的中心静脉导管感染的主要原因。

Objective To study the infection cause and prevention measures of central venous catheter with Cuff of patients with maintenance hemodialysis. Methods 150 cases of patients with maintenance hemodialysis in our hospital from April2013 to April 2016 were convenient selected for analysis, and the infection rate of central venous catheter with Cuff of patients, bacterial distribution and related infection factor were analyzed. Results There were 57 cases of patients with infection, and the infection rate was 38.00%, and there were 8 strains by the bacterial examination, including 23 strains of gamnegative bacteria, accounting for 60.53%, 8 strains of gram positive coccus, accounting for 21.05%, and 7 strains of fungus,accounting for 18.42%, and the infection rate of patients whose age was below 60 and whose catheter puncture time was less than 3 was respectively 28.96% and 17.54%, Than ololer over 60, taigeted more thcm three times lowerinfection rate（45.68% and 82.46%）and the difference had statistical significance（P〈0.05）, and the infection rate of patients with diabetes was obviously higher than that of patients without diabetes,（53.33% vs 31.43%）, and the difference had statistical significance（P〈0.05）. Conclusion The catheter puncture time of people whose age was more than 60 is more, the diabetes history is the major cause of central venous catheter with Cuff of patients with maintenance hemodialysis.