心脏手术患者导管相关性血流感染的临床特点与危险因素分析

Clinical characteristics,immune function and risk factors of catheter-related bloodstream infections in children with cardiac surgery

目的探究心脏手术患者导管相关性感染的危险因素及其免疫功能与感染的相关性分析,为临床治疗提供参考依据。方法选择2010年1月-2016年1月在医院心脏外科收治的720例需要心脏手术治疗的冠心病及瓣膜病患者,依据患者术后是否发生感染分为感染组和对照组,各17例,分析病原菌分布及危险因素。结果有17例患者出现导管相关性血流感染,感染率为2.36%,共检出病原菌31株,以革兰阴性菌为主,共18株占58.06%;患者的年龄、置管时间、有无经验性使用抗菌药物、抗菌药物使用的种类、住院时间以及白细胞数目的多少是导致患者术后发生导管相关性血流感染的相关危险因素(P<0.05)。结论通过对心脏手术后患者导管相关血流感染的临床特点、免疫功能以及危险因素的相关性进行分析,这在一定程度上对于了解患者病情,给予合理治疗方案提供了一定的参考依据,其最重要的是为预防感染的发生提供了一些措施。

OBJECTIVE To explore the risk factors of catheter-related infections in children with cardiac surgery and the correlation between immune function and infections,so as to provide references for clinical treatment.METHODS A total of 720 children with coronary heart disease and valvular disease who needed cardiac surgery were enrolled in our hospital from Jan.2010 to Jan.2016.They were divided into infection group and control group according to whether the infections occurred,with 17 cases in each group.The pathogens distribution and risk factors were analyzed.RESULTS There were 17 children with catheter-related bloodstream infections,and the infection rate was 2.36%.Totally 31 strains of pathogens were detected,which were mainly 18 strains of gramnegative bacteria,accounting for 58.06%.The age of the patients,time of catheterization,use of antimicrobial agents,types of antimicrobial agents,length of stay and number of leukocytes were risk factors for catheter-related bloodstream infections in children after surgery（P〈0.05）.CONCLUSION The clinical characteristics,immune function and the correlation of risk factors related to catheter-related bloodstream infections in patient with cardiac surgery were analyzed,which provided some references for understanding the patient′s condition and giving reasonable treatment plan.The most important thing is to provide some measures to prevent the occurrence of infections.