CAJ | 학술논문

目的：分析神经外科 ICU 中心静脉置管相关感染因素，并提出相应的护理对策。方法：回顾性分析2008年1月~2012年12月42例经锁骨下中心静脉置管感染的患者住院资料进行调查研究，分析引起置管感染的相关因素。结果：我科经锁骨下中心静脉置管的感染率为9.29%。NICU 中心静脉置管相关感染主要包括：患者导管留置时间、颅脑损伤程度、血糖水平、置管人员技术水平及置管时机等。42例感染患者中总计培养菌株69株，其中革兰阳性菌38株（55.07%），革兰阴性菌26株（37.68%），真菌5株（7.25%）。发生导管相关感染的患者预后情况较未发生导管相关感染的患者差（ P ＜0.05）。结论：严格控制中心静脉导管留置时间，严格无菌操作，针对中心静脉置管感染的相关因素，制定合理的预防和护理措施对减少中心静脉置管相关感染的发生具有重要临床意义。
목적：분석신경외과 ICU 중심정맥치관상관감염인소，병제출상응적호리대책。방법：회고성분석2008년1월~2012년12월42례경쇄골하중심정맥치관감염적환자주원자료진행조사연구，분석인기치관감염적상관인소。결과：아과경쇄골하중심정맥치관적감염솔위9.29%。NICU 중심정맥치관상관감염주요포괄：환자도관류치시간、로뇌손상정도、혈당수평、치관인원기술수평급치관시궤등。42례감염환자중총계배양균주69주，기중혁란양성균38주（55.07%），혁란음성균26주（37.68%），진균5주（7.25%）。발생도관상관감염적환자예후정황교미발생도관상관감염적환자차（ P ＜0.05）。결론：엄격공제중심정맥도관류치시간，엄격무균조작，침대중심정맥치관감염적상관인소，제정합리적예방화호리조시대감소중심정맥치관상관감염적발생구유중요림상의의。
Objective:To analyze the related factors causing PICC infection in critically ill patients in neurosurgical department and put forward nursing countermeasures. Methods:The hospitalization data and information of 42 patients who received subclavian PICC(from January 2008 to December 2012)were retrospectively analyzed to find out the related factors causing PICC infection. Results:The infection rate of PICC was 9. 29% in our department and it mainly included indwelling time of catheter,the degree of traumatic brain injury,blood glucose level,the skill of nurses and the time of catheterization. A total of 69 strains were cultured in 42 patients with infection,of which 38 strains were gram negative bacilli(55. 07% )and 26 strains were gram positive bacilli(37. 68% ),5 strains were fungi(7. 25% ). The prognosis of patients with catheter - related infection was poor compared with those who were not infected(P < 0. 05). Conclusion:The strict control of the indwelling time of catheter,strict aseptic operation,the targeted and reasonable prevention and nursing measures has important clinical significance for reducing the occurrence of catheter - related infection.