期刊文献+

深静脉置管感染因素分析 被引量:3

Analysis on bacterial infection factors in deep venous catheterization
在线阅读 免费下载
分享 导出
摘要 目的通过研究经皮穿刺深静脉置管术与感染的关系,分析深静脉置管导管相关性感染的发病率以及影响深静脉置管感染的相关因素以采取有效的防控措施降低感染的发生。方法采用回顾性调查方法,将2005年1月至2012年12月我院收治的60例深静脉置管患者按置管部位分为颈内静脉组26例和股静脉组34例,出现发热者采集导管内血培养及导管培养,对感染发生率、感染发生的时间、感染发生的部位、患者的血流量和不同病因患者感染发生率进行了统计。结果深静脉置管放置时间越长,导管相关性感染发生越多。股静脉穿刺组感染发生时间为(26.5±9.6)d,颈内静脉穿刺组感染发生时间为(35.4±6.8)d。本研究深静脉置管导管相关性感染发生率为21.67%,其中股静脉置管的感染发生率为32.3%,颈内静脉置管的感染发生率为7.6%,股静脉置管感染发生率远高于颈内静脉置管(P〈0.01)。在病因方面,糖尿病肾脏疾病组感染率为所有组别中最高(33.3%),与其他组比较存在显著差异(P〈O.05)。慢性肾小球肾炎组(16.7%),高血压肾动脉硬化组(16.7%),多囊肾病(14.2%)、狼疮肾炎(20%)之间无明显差异。患者血流量在200ml/min以上时,导管相关性感染的发生率较低,为9.5%;血流量〈200ml/min时,感染的发生率为28.2%,二者比较,存在显著差异(P〈0.05)。细菌培养病原体以革兰阳性球菌为主(53.85%),其中金黄色葡萄球菌占30.76%,表皮葡萄球菌占23.08%。结论为减少感染发生,颈内静脉置管应作为中心静脉置管的首选部位,导管留置时间应尽可能缩短。对有易感因素的患者,如原发病为糖尿病时血流量较低,应加强无菌操作,一旦发生感染,应立即治疗。 Objective Through studying the relationship between transcutaneous indwelling catheter in deep vein and catheterization-related infection to analyze the incidence rate of infection and related factors of catheter-related infetction to provide effective prevention and control measures to re- duce infection. Methods A retrospective survey from Jan 2005 to Dec 2012 was conducted in the he- modialysis center of the Second Peoples Hospital. Sixty chronic renal failure patients subject to cathe- terization in deep veins, among which 34 cases in femoral vein and 26 cases in interal jugular vein. Blood from the catheter and the catheter itself was collected for normal bacterial culture once the patients had fever. The incidence rate of infection, the infection time, the infection site, the blood flow of hemodial-ysis and the infection rate between patients of different causes were statisticed. Results The longer the time of catheterizing in deep vein was, the more correlated infection occurred. The infection time in femoral vein puncture group and interal jugular vein puncture group was (26. 5 ±9. 6) days and (35. 4 ± 6. 8) days respectively. The catheter-related infection rate in this study was 21.67%, of which the femoral vein catheter infection rate was 32. 3 %, and the internal jugular vein catheter infection rate was 7. 6%. The incidence of femoral vein infection was higher than the internal jugular vein infection(P〈 0. 01 ). The infection rate in diabetic kidney disease group(33. 3 %) was significantly higher than other groups, including chronic glomerulonephritis group, hypertension group, polycystic kidney group andlupus nephritis group (P〈0. 05). There was no significant difference among chronic glomerulonephri-tis group( 16. 7 %), hypertension group( 16. 7 %), polycystic kidney group( 14. 2 %), and lupus nephritis group(20%). When blood flow was above 200 ml/min, catheter-related infection rate is 9. 5%, which was significantly lower than that under the blood flow of be
作者 于颖吉 蔡威巍 纪培颖 许雁集 金玫萍 来纯 徐树人 YU Ying-ji, CAI Wei-wei, JI Pei- ying, XU Yan-ji , JIN Mei ping, ZHU Chun , XU Shu-ren. Department of Nephrology , the Second People ' s Hospital of Shanghai, Shanghai 200011,China
出处 《临床肾脏病杂志》 2014年第6期359-363,共5页 Journal Of Clinical Nephrology
基金 上海市黄浦区卫生局科技项目(Nn2011-HGG-29).
关键词 深静脉置管 血液透析 感染 Deep venous catherizatiom Hemodialysis Infection
  • 相关文献

参考文献21

  • 1Vanholder R,Ringoir S, Dhondt A, et al. Phagocytosis in ure- mic and hemodialysis patients:A prospective and cross section- al study. Kidney Int, 1991,39:320-327. 被引量:1
  • 2Hoen B, Paul DA, Hestin D, et al. EPIBACDIAL: A multi-cen- ter prospective study of risk factors for bacteremia in chronic hemodialysis patients. J Am Soe Nephrol, 1998,9:869-876. 被引量:1
  • 3Powe NR, Jaar B, Furth SL, et al. Septicemia in dialysis pa- tients:Inddence risk factors, and prognosis. Kidney Int, 1999, 55 : 1081-1090. 被引量:1
  • 4Adal KA,Farr BM. Central venous cat heterrelated infections: A review. Nutrition, 1996,12:208-213. 被引量:1
  • 5傅君舟,秦曙光,李剑文,杨京芝,熊剑辉.血透用颈内静脉导管相关感染的临床研究[J].实用医学杂志,2001,17(5):397-398. 被引量:22
  • 6薛欣盛,张中伟,周琰.危重症中心静脉插管相关性感染致病菌分析及预防[J].中国实用外科杂志,2004,24(3):156-157. 被引量:20
  • 7Hung KY, Tsai TJ, Yen CJ, et al. Infection associated with double lumen cathetenzation for temporary hemodialysis: Expe- rience of 168 cases. Nephrol Dial Transplant, 1995, 10: 247- 253. 被引量:1
  • 8崔秀兰.血液透析患者深静脉置管术后相关感染因素分析及预防[J].中国医药指南,2009(16):13-15. 被引量:8
  • 9Saxena AK, Panhotra BR, Chopra RA. Advancing age and the risk of nasal carriage of Staphylococcus aureus among patients on long-term hospital-based hemodialysis. Ann Saudi Med, 2004,24 : 337-342. 被引量:1
  • 10Saxena AK, Panhotra BR, Venkateshappa CK, et al. The im- pact of nasal carriage of methieillin-resistant and methicillin- susceptible Staphylococcus a ureus(MRSA& MSSA) on vas- cular access-related septicemia among patients with type-II dia- betes on dialysis. Ren Fail, 2002,24: 763-777. 被引量:1

二级参考文献43

共引文献146

同被引文献17

引证文献3

二级引证文献1

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈