中心静脉置管后败血症的临床分析与防治

Intravenous Catheter-related Sepsis: Clinical Analysis and Treatment

目的 探讨深静脉置管后败血症的临床特点与防治措施。方法 对 35例中心静脉置管后导管败血症(CRS)的患者进行临床分析 ,包括导管细菌培养、药敏试验、防治措施等。结果 14例患者经拔管 2～ 3d后体温降至正常 ,10例均在拔管次日体温降至正常 ,3例拔管后根据药敏调整抗生素感染得到控制 ,8例因原发病重、恶性肿瘤加上 CRS而间接导致死亡 ;CRS常见病原体真菌、革兰阴性杆菌、然后是革兰阳性球菌。革兰阳性球菌对万古霉素最敏感 ,革兰阴性杆菌对阿米卡星及头孢他啶的敏感率 6 0 %。结论 CRS的有效处理方法是拔除深静脉的导管。

OBJECTIVE To study the clinical characteristics and prevention and treatment of the intravenous catheter related sepsis(CRS).METHODS Clinical analyses included catheter bacteria culture, antibiotics sensitivity test and their prevention and treatment methods were preformed in 35 patients with intravenous CRS. RESULTS The temperature of 14 patients normalized 2 to 3 days and of 10 patients normalized the next day after removing their catheter. Three patients′ sepsis was controlled after the antibiotic treatment according to the sensitive test. Eight patients were dead because of their severe primary disease such as cancers and indirectly because of the CRS. The common pathogens in CRS were fungi, Gram negative bacilli and then the Gram positive cocci. The Gram positive cocci. were sensitive to vancomycin but the Gram negative ones were only about 60% sensitive to the amikacin and cefradine. CONCLUSIONS The most effective treatment of CRS is to remove the catheter.