| 段会妮.中心静脉导管相关性血流感染病原学及危险因素分析[J].上海护理,2017,17(4): |
| 中心静脉导管相关性血流感染病原学及危险因素分析 |
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| DOI： |
| 中文关键词: 中心静脉导管 相关性血流感染 病原学 危险因素 |
| 英文关键词:Central venous catheter Associated bloodstream infection Etiology Risk factors |
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| 中文摘要: |
| 目的：分析探讨中心静脉导管的相关血流感染（CVC-R1)的发生的危险影响因素，不同病区的细菌感染差异和药敏情况，为临床降低静脉导管感染、提高护理安全和护理质量提供循证医学的依据。方法：本次研究对2015年5月-2016年5月期间在我院治疗时采用中心静脉导管的1433例患者的临床资料进行回顾性分析，针对其中相关性血流感染组患者进行感染病原菌情况分析，计算出感染组患者病原菌构成情况和其与CVC-1感染率间的关系，同时针对感染患者的一般资料、疾病情况、中心静脉导管留置情况以及导管情况、患者置管前身体状况等相关指标因素进行分析，探讨其对于中心静脉导管相关血流感染的影响情况；结果：1433例患者中有311例发生中心静脉导管感染情况，感染率为21.7%。其中导管血流感染23例，感染率为1.61%，原发性感染19例，继发性感染4例。23例血流感染患者标本共计培养出病原菌27株，其主要以金黄色葡萄菌、鲍曼不动杆菌以及凝固酶阴性葡萄球均为主要为病原菌种。23例例患者中有16例患者超过65岁，4例患者小于14岁。共8例患者未使用过抗菌药物，而有8例患者使用抗生素超过7d，18人导管留置时间超过该21d；结论：患者年龄、导管留置时间、抗菌类药物使用情况等多种因素均是造成中心静脉导管相关性血流感染的重要原因，临床护理时，护理人员应密切关注患者的情况，严格按照相关标准执行护理任务，正确对患者感染情况进行评估，并及时给予患者相应的干预措施。 |
| 英文摘要: |
| Purpose:To analyze the risk factors of the occurrence of central venous catheter related bloodstream infection，differences of pathogen and drug sensitivity in different endemic areas,and to provide evidence for reducing the infection of venous catheter and improvethe quality of nursing safety.Method：In this study, we retrospectively analyzed the clinical data of 1433 patients with central venous catheter in our hospital during the period from 2015.05-2016.05. patients were divided into infection group and non infection group, and the baseline parametersbefore or after CVC, composition of pathogenic bacteria in patients and its relationship with CVC-1 infection were analyzedinvestigate the risk factorsof the central venous catheter related infection.Result：Infection occurred in 311 of 1433 patients (21.7%) with central venous catheter.Among them,23 cases (1.61%) was bloodstream infection, 19 cases of primary infectionand4 cases of secondary infection.Form the blood samples of 23 patients with bloodstream infection,27 strains of pathogenic bacteria were cultured,including Staphylococcus aureus, Candida and Coagulase-negative Staphylococcus.Of the 23 patients, 16 were over 65 years old,4 cases were less than 14 years old.A total of 8 cases did not use antibacterial drugs，and catheter indwelling time of 18 casses exceeded 21days.Conclusion:Theage, catheter indwelling time, anduse of antibioticsare the main causes of central venous catheter related bloodstream infection.Nurses should pay close attention to the patient's situation,strictly follow the relevant standards to carry out the task of nursing,correctly assess the patient's infection,and to give the corresponding intervention measures in time. |
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