摘要
目的探讨ICU内中心静脉导管相关性感染(CVC-RI)的病原学及临床特点。方法分析32例CVC-RI确诊患者的菌群分布及细菌耐药情况,以及引起CVC-RI的相关因素。结果32例CVC-RI患者中,共分离出菌株35株,其中革兰阳性菌14株,革兰阴性菌10株,真菌11株;置管7天后CVC-RI发生率逐渐增高。与对照组比较,CVC-RI组患者年龄较大(P<0·05),住院时间、导管留置入时间较长(P<0·05),入科时APACHEⅡ评分较高(P<0·05),血清白蛋白和Glasgow评分较低(P<0·05),给予胃肠内营养者较少(P<0·05),气管切开数较多(P<0·05)。结论对于住院时间较长、血清白蛋白低、APACHEⅡ评分较高、Glasgow评分较低、行胃肠外营养及高龄气管切开患者,尤其应注意CVC-RI的发生;重视抗生素的合理应用,应根据已存在的危险因素采取相应措施。
Objective To study the etiology and clinical characteristics of central venous catheter-related infection （CVC-RI） in ICU. Methods The common pathogens and the risk factors of CVC-RI were analyzed in 32 patients with central venous catheter-related infection. Results Among 32 patients with CVC-RI, 35 pathogens were isolated,including 14 gram-positive bacterium, 10 gram-negative bacterium and 11 fungi. The incidence of CVC-RI increased gradually after the seventh day of the insertion of catheter. Compared with the control, 32 cases with CVC-RI were older（ P 〈 0. 05 ） ,had longer time of inserting catheter an staying in hospital（ P 〈 0. 05 ）, higher APACHE Ⅱ score （ P 〈 0. 05 ）, lower albumin level and Glasgow coma scales （ P 〈 0.05 ）, less enteral nutrition （ P 〈 0. 05 ） and more incision of trachea（ P 〈 0. 05 ）. Conclusion CVC-RI should be taken precaution in older patients with hypoalbuminemia , high APACHE Ⅱ score, low Glasgow coma scales, incision of trachea or parenteral nutrition. Antibiotic should be used reasonably and a corresponding measure be carried out according to risk factors.
出处
《安徽医科大学学报》
CAS
北大核心
2006年第6期698-701,共4页
Acta Universitatis Medicinalis Anhui
