PICC 相关性血流感染的原因分析及护理对策

摘要

[目的]了解经外周静脉置入中心静脉导管(PICC)病人发生导管相关性血流感染(CRBSI)情况及相关因素，并制定对策。[方法]回顾性调查2013年11月—2014年7月我院2142例 PICC 置管病人 CRBSI 发生率及其原因。[结果]2142例病人中确诊CRBSI 24例，发生率为1.12%，其中操作中同一部位反复穿刺(针尖未拔出，在皮下探索式穿刺≥3次)5例，留置时间大于30 d 17例，经肘关节下静脉留置22例，病人带管出院(可能与病人依从性差、当地维护不规范等有关)23例。[结论]熟练的置管技术、满足治疗情况下较短的留置时间、经上臂置管、完整的宣教内容、病人良好的依从性及规范的维护都是降低 CRBSI 发生率的有效措施。%Objective:To know about the catheter related bloodstream infections phenomenon in patients with Peripherally Inserted Central Venous Catheters (PICC)and related factors,and to make the countermeasures. Methods:Retrospective research method was used to investigate the incidence of CRBSI in 2142 cases of pa-tients with PICC and the reasons from November in 2013 to July in 2014 in Xiangya hospital of central south u-niversity.Results:In 2142 cases,24 cases were diagnosed as CRBSI,and the incidence was 1.12%.In operation there were 5 cases with repeatedly puncture in the same place (Not pulling out the needle,subcutaneous explor-atory puncture ≥3 times),17 cases with indwelling time greater than 30 days,22 cases with indwelling vein un-der the elbow,23 cases with pipe discharge (possibly related with poor compliance of patients and local mainte-nance irregularities).Conclusion:Skilled catheter technology,meeting shorter retention time under treatment, the upper arm catheterization,complete mission content and patients'good compliance and standard maintenance are effective measures to reduce the incidence of CRBSI.