Objective To study the risk factors for central venous catheter-related infections(CVC-RI)in ICU patients with total parenteral nutrition(TPN)therapy,so as to provide basis for clinical nursing optimization and prevention of infection. Methods Clinical information of 156 patients,who had underwent the TPN therapy with central venous catheterization in the ICU from Mar 2012 to Mar 2014 were retrospectively analyzed,used single factor analysis and multiple factors logistic analysis to identify the risk factors for CVC-RI. Meanwhile,the stimulation and easy to plug caused by TPN therapy with high nutrient concentration on central venous were also the important factors for CVC-RI. Results In 156 cases,there were 21 patients with CVC-RI,the infection rate was 13.46%;logistic regression analysis showed Operation technology(β=1.512, OR=4.536);indwelling catheter time(β=1.406,OR=4.080); indwelling position:Internal and external vein compared with femoral vein(β=-0.602,OR=0.550);compared to the subclavian vein and femoral vein(β=-0.980,OR=0.375);and patients age(β=0.767,OR=2.153)were risk factors for the occurrence of CVC-RI.At the same time,TPN treatment with high concentration nutritional medicine can stimulate central vein, easy to plug was also an important factor in CVC-RI. Conciusion Strengthen skills training,strict operation qualification admittance,perfect quality supervision system and the establishment hospital CVC - RI prevention guidelines can reduce the incidence of infection,improve the security of central venous catheter infusion nursing.%目的 探讨ICU全胃肠外营养(TPN)治疗患者经中心静脉置管相关性感染(CVC-RI)的危险因素,为临床优化护理及预防感染提供依据.方法 回顾性分析2012年3月至2014年3月156例接受TPN治疗的ICU中心静脉置管患者的临床资料,采用单因素分析及多因素Logistic分析,找出导致患者CVC-RI的危险因素.结果 156例患者中21例患者发生CVC-RI,感染率13.46%;Logistic回归分析结果显示,操作技术(β=1.512,OR=4.536);置导时间(β=1.406,OR=4.080);置管部位:颈内、外静脉与股静脉比较分析(β=-0.602,OR=0.550)、锁骨下静脉与股静脉相比(β=-0.980,OR=0.375)、患者年龄(β=0.767,OR=2.153)是发生CVC-RI的危险因素.TPN治疗应用营养药物浓度高对中心静脉造成刺激、易堵塞也是CVC-RI重要影响因素.结论 加强技能培训、严格操作资格准入、健全质量监管体系,医院建立CVC-RI的预防指引以降低感染发生率,提高中心静脉置管输液护理的安全性.
展开▼
