ICU中心静脉置管感染相关危险因素分析、病原菌分布与防范对策

Analysis of risk factors related to central venous catheterization infection in ICU,distribution of pathogens and preventive measures

目的探讨导致ICU中心静脉置管感染的相关危险因素,分析其病原菌分布,制定有效的防范对策。方法选取2015年2月至2018年2月我院收治的60例ICU中心静脉置管患者为研究对象,收集其相关资料,采用单因素和多因素logistic回归模型,分析导致中心静脉置管感染的危险因素。结果60例患者中感染15例,从中检出病原菌80株,其中革兰氏阴性菌49株,占61.25%;革兰阳性菌29株,占36.25%;真菌2株,占2.50%。张力贴膜、未使用无菌棉球按压、三通接口松动、污染及护理人员未严格执行无菌操作为导致ICU中心静脉置管感染的独立危险因素。结论导致ICU中心静脉置管发生感染的因素较多,只有明确危险因素,确定各种病原菌的具体分布情况,制定有效的防护措施,才能避免或减少中心静脉置管感染的发生。

Objective To explore the risk factors related to central venous catheterization infection in ICU,analyze the distribution of pathogens,and develop effective preventive measures.Methods We selected 60 cases of patients with ICU central venous catheterization admitted to our hospital from February 2015 to February 2018 as a study object.The relevant data were collected,and univariate and multivariate logistic regression models were used to analyze the risk factor of the central venous catheterization infection.Results In the 60 cases of patients,15 cases were infected,and 80 strains of pathogens were detected,of which 49 were Gram-negative bacteria with 61.25%;29 cases of were Gram-positive bacteria with 36.25%;2 cases of were fungi with 2.50%.Tensile filming,failure to use sterile cotton balls,loosening of the three-way interface,contamination,and inadequate aseptic operation of the nursing staff were independent risk factors for central venous catheterization infection in the ICU.Conclusion There were many factors leading to the infection of central venous catheterization in ICU.Only the specific risk factors were determined,the concrete distribution of various pathogens was determined,and effective protective measures were taken to avoid or reduce the occurrence of central venous catheterization infection.