CAJ | 학술논문

目的：了解综合IC U血液净化患者导管相关性感染发生率和病原菌组成，分析导管相关性感染危险因素，为减少导管相关性感染治疗策略提供临床数据。方法通过对2011年1月－2013年l2月医院综合IC U行血液净化245例患者中心静脉导管进行回顾性分析，对导管感染相关危险因素进行多因素非条件 logistic回归分析，采用SPSS13．0进行统计处理。结果245例血液透析患者中发生导管相关性感染23例，感染率为9．39％；检出病原菌以金黄色葡萄球菌为主，共9株占39．13％；单因素分析显示，年龄、APACHEⅡ评分、抗菌药物使用、股静脉置管、置管时间、使用导管输液、免疫抑制剂应用是导管感染的高危因素；多因素 logistic回归分析，结果显示，年龄、APACHEⅡ评分、股静脉置管、置管时间和免疫抑制剂应用是导管相关性感染的独立危险因素（P＜0．05）。结论应加强血液净化治疗患者导管相关性感染危险因素控制，以减少感染发生。
목적：료해종합IC U혈액정화환자도관상관성감염발생솔화병원균조성，분석도관상관성감염위험인소，위감소도관상관성감염치료책략제공림상수거。방법통과대2011년1월－2013년l2월의원종합IC U행혈액정화245례환자중심정맥도관진행회고성분석，대도관감염상관위험인소진행다인소비조건 logistic회귀분석，채용SPSS13．0진행통계처리。결과245례혈액투석환자중발생도관상관성감염23례，감염솔위9．39％；검출병원균이금황색포도구균위주，공9주점39．13％；단인소분석현시，년령、APACHEⅡ평분、항균약물사용、고정맥치관、치관시간、사용도관수액、면역억제제응용시도관감염적고위인소；다인소 logistic회귀분석，결과현시，년령、APACHEⅡ평분、고정맥치관、치관시간화면역억제제응용시도관상관성감염적독립위험인소（P＜0．05）。결론응가강혈액정화치료환자도관상관성감염위험인소공제，이감소감염발생。
OBJECTIVE To investigate the occurrence rate and distribution of pathogens and analyze the risk factors of the catheter associated infections in blood purification patients in ICU in order to supply an appropriately thera‐peutic strategy .METHODS From Jan .2011 to Dec .2013 ,a total of 245 patients who underwent blood purifica‐tion were enrolled for this retrospective study .The catheter associated risk factors were analyzed by multivariate and unconditional logistic regression analysis .All data were dealt with SPSS 13 .0 software .RESULTS Of the 245 cases of patients who underwent continuous blood purification in the ICU ,the nosocomial infections occurred in 23 cases with the incidence rate of 9 .39% .Of 23 cases of infections ,39 .13% pathogens were mainly Staphylococcus aureu .The univariate analysis showed that age ,APACHEⅡ score ,administration of antibiotics ,femoral vein catheterization ,duration of indwelling catheterization ,infusion through vascular for blood purification and admin‐istration of immunosuppressive agents were related with the incidence of the catheter associated infection .Logistic regression analysis suggested that the age ,APACHEⅡ score ,femoral vein catheterization ,duration of indwelling catheterization and administration of immunosuppressive agents were the independent risk factors responsible for central venous catheter‐related infections (P<0 .05) .CONCLUSION We should pay more attention to control the risk factors responsible for central venous catheter‐related infections to reduce the incidence of infections .