CAJ | 학술논문

目的：了解批量重度烧伤患者中心静脉置管相关血流感染情况、危险因素及感染防控措施效果。方法某院2014年8月抢救了9例重度烧伤患者，对其行中心静脉置管术，置管全程对患者进行感染防控干预。结果9例患者共进行中心静脉置管30例次，置管总日数227 d，其中2例患者股静脉三腔置管细菌培养阳性，导管相关血流感染（CRBSI）发病率为8．81‰；其中1例患者培养出屎肠球菌，另1例患者培养出鲍曼不动杆菌和嗜麦芽窄食单胞菌。2例 CRBSI 患者均为股静脉置管，置管部位均为创面，置管时间均≥7 d，均为三腔置管，且患者Ⅲ°烧伤面积≥60％。经及时拔除导管和使用抗菌药物，2例感染患者均治愈。结论中心静脉置管有利于危重烧伤患者长期、安全、有效地补液，但其可导致 CRBSI；对中心静脉导管置管患者进行全程感染防控干预，选用少腔导管，有助于降低 CRBSI 的发生。
목적：료해비량중도소상환자중심정맥치관상관혈류감염정황、위험인소급감염방공조시효과。방법모원2014년8월창구료9례중도소상환자，대기행중심정맥치관술，치관전정대환자진행감염방공간예。결과9례환자공진행중심정맥치관30례차，치관총일수227 d，기중2례환자고정맥삼강치관세균배양양성，도관상관혈류감염（CRBSI）발병솔위8．81‰；기중1례환자배양출시장구균，령1례환자배양출포만불동간균화기맥아착식단포균。2례 CRBSI 환자균위고정맥치관，치관부위균위창면，치관시간균≥7 d，균위삼강치관，차환자Ⅲ°소상면적≥60％。경급시발제도관화사용항균약물，2례감염환자균치유。결론중심정맥치관유리우위중소상환자장기、안전、유효지보액，단기가도치 CRBSI；대중심정맥도관치관환자진행전정감염방공간예，선용소강도관，유조우강저 CRBSI 적발생。
Objective To investigate the occurrence of central venous catheter-related bloodstream infection(CRB-SI)in mass severe burn patients,evaluate related risk factors for infection,and effectiveness of prevention and con-trol measures.Methods In August 2014,9 cases of severe burn patients were rescued in a hospital,all patients re-ceived CVC,infection prevention and control intervention measures were performed during the whole process of catheterization.Results All patients received 30 episodes of CVC,total CVC-days were 227 days,bacterial culture for three-cavity catheters of femoral veins in 2 patients were positive,incidence of CRBSI was 8.81 ‰;1 patient was isolated Enterococcus faecium ,1 isolated both Acinetobacter baumannii and Stenotrophomonas maltophilia .2 CRB-SI patients received femoral vein catheterization,catheterization site was trauma surface,duration of catheterization were both ≥7 days,both used three-cavity catheters,and third degree burns were ≥60%,both patients were cured after timely removal of catheters and receiving of antimicrobial agents.Conclusion CVC is helpful for long term, safe and effective fluid infusion,but it can cause CRBSI;infection prevention and control intervention for patients receiving CVC during the whole process of catheterization can reduce the occurrence of CRBSI.