重症监护室患者中心静脉置管的感染风险分析与预防控制护理

Infection risk analysis and prevention and control nursing of central venous catheterization of patients in ICU

目的:探讨风险分级预防控制护理模式在感染控制中的临床应用价值。方法:选取医院重症监护室(ICU)收治的304例中心静脉置管(CVC)患者,采用随机数表法将其分为对照组和观察组,每组152例。对照组采用常规护理模式,观察组采用风险分级预防控制护理模式,分析两组CVC患者感染因素,对比分析两组感染控制效果和临床护理质量。结果:CVC患者的年龄、基础疾病情况、CVC置管数量和置管时间是主要感染风险因素。观察组患者呼吸机相关肺炎、尿路感染率、血流感染率、总感染率和并发症比例均低于对照组,差异有统计学意义(χ^(2)=5.680,χ^(2)=4.269,χ^(2)=4.622,χ^(2)=15.206,χ^(2)=7.699;P<0.05)。观察组的导管置留时间、ICU住院时间和出院时生活质量核心问卷(QLQ-C30)评分好于对照组,差异有统计学意义(t=2.441,t=48.65,t=2.185;P<0.05)。结论:风险分级预防控制护理模式能发现患者治疗中存在的感染风险因素,降低患者感染率,提高护理工作针对性,提升护理质量和临床诊疗水平。

Objective:To explore the clinical application value of risk classification prevention and control nursing mode in infection control.Methods:304 patients with central venous catheterization(CVC)admitted to ICU were selected and divided into a control group and an observation group by random number table method,with 152 cases in each group.The control group adopted routine nursing mode,and the observation group adopted risk grading prevention and control nursing mode.The effect of infection control and the quality of clinical nursing were compared and analyzed between the two groups.Results:The age of CVC patients,the underlying disease,the number and duration of CVC catheterization were the main risk factors for infection.The rate of ventilator-related pneumonia,urinary tract infection,blood flow infection,total infection rate and complication rate in the observation group were lower than those in the control group,and the differences were statistically significant(χ^(2)=5.680,χ^(2)=4.269,χ^(2)=4.622,χ^(2)=15.206,χ^(2)=7.699;P<0.05).The catheter retention time,ICU hospitalization time and QLQ-C30 score at discharge in the observation group were better than those in the control group,and the differences were statistically significant(t=2.441,t=48.65,t=2.185;P<0.05).Conclusion:The risk grading prevention and control nursing model can effectively find out the risk factors of infection in the treatment of patients,reduce the infection rate of patients,improve the pertinence of nursing work,improve the nursing quality and level of clinical diagnosis and treatment.