CAJ | 학술논문

目的探讨中心静脉导管相关性血流感染(CRBSI)的临床特征和发病因素.方法对新生儿重症监护病房发生的21例CRBSI患儿的临床资料进行回顾性分析.结果胎龄28～34周、出生体质量＜1 500 g、导管留置时间在3周以上的早产儿是CRBSI的高发人群,以喂养不耐受、不明原因的心率加快、体温不稳、应激性血糖升高及顽固性代谢性酸中毒为主要临床表现.感染的病原以凝固酶阴性的葡萄球菌为主(35.7%),其次分别为肺炎克雷伯杆菌(11.9%)、金黄色葡萄球菌(9.5%)、铜绿假单胞菌(7.1%)及阴沟肠杆菌(7.1%).结论 CRBSI患儿临床表现隐匿,缩短导管留置时间及胃肠外营养时间、加强全身的营养支持是预防CRBSI的有效措施.
목적 탐토중심정맥도관상관성혈류감염(CRBSI)적림상특정화발병인소.방법 대신생인중증감호병방발생적21례CRBSI환인적림상자료진행회고성분석.결과 태령28～34주、출생체질량＜1 500 g、도관류치시간재3주이상적조산인시CRBSI적고발인군,이위양불내수、불명원인적심솔가쾌、체온불은、응격성혈당승고급완고성대사성산중독위주요림상표현.감염적병원이응고매음성적포도구균위주(35.7%),기차분별위폐염극뢰백간균(11.9%)、금황색포도구균(9.5%)、동록가단포균(7.1%)급음구장간균(7.1%).결론 CRBSI환인림상표현은닉,축단도관류치시간급위장외영양시간、가강전신적영양지지시예방CRBSI적유효조시.
Objective To find out the clinical characteristics and morbility factors of intravascular catheterrelated bloodstream infection(CRBSI). Methods Totally 21 patients who had CRBSI in neonatal intensive care unit were investigated retrospectively. Results The distribution of CRBSI was higher in very low birthweight preterm infants, gestational age among 28 ～34week, whose intravascular catheter remaining time were obove three weeks. Principal clinical presentation of CRBSI were poor feeding, unaocountable tachycardia, temperature instability, stressed hyperglycemia,refractoriness metabolic acidosis. The most common pathogens were coagulase-negative staphylococci (35.7%), Klebsiella pneumonia, bacilli ( 11.9% ) Staphylococcus aureus (9.5 % ), Pseudomonas aeruginosa( 7. 1% )and Enterobacter cloacae(7.1% ). Conclusions The clinical manifestations of CRBSI were concealment,and reducing the time of inserted central catherization and total parenteral nutrition, strengthening the nutrition of body would provide effective prevention of CRBSI.