PICC在SICU控制血管导管相关性感染发病率中的应用研究

Study on Using PICC to Control the Incidence of Catheter-Related Blood Stream Infections in SICU

摘要: 目的：探讨中心静脉导管(Central Venous Catheters, CVC)和经外周静脉植入中心静脉导管(Peripherally Inserted Central Catheter, PICC)在长期入住外科重症监护病房(Surgical Intensive Care Units, SICU)的患者中导管相关血流感染(Catheter-Related Blood Stream Infections, CR-BSI)发生率。方法：随机观察并分析长期入住SICU的90例患者更换抗感染中心静脉导管或PICC置管治疗后的导管相关性感染发生情况。按照感染诊断标准，Logistic回归分析CR-BSI确定推测。结果：CVC置管感染8例(感染率8.6/千导管日)，PICC置管感染1例(感染率1.2/千导管日)。CVC置管时间为(19.74 ± 2.14) d，其中发生感染的CVC为置管(13.87 ± 1.56) d；PICC置管时间为(30.41 ± 3.58) d，发生感染的时间为置管第28d。Logistic回归分析表明，置管天数是唯-CVC感染的预测因子(P=0.013)。结论：缩短CVC留置时间，长期入住ICU患者用PICC代替CVC可能降低CR-BSI的发生。

Abstract: Objective: To study the incidence of CR-BSI (Catheter-Related Blood Stream Infections) of CVC (Central Venous Catheters) and PICC (Peripherally Inserted Central Catheter) in SICU. Methods: Random observation and analysis on the catheter-related infections of the 90 patients’ replacement of CVC or PICC in SICU. According to the diagnostic criteria of infection, CR-BSI Logistic regression analysis is used to determine speculation. Results: 8 cases of infection in CVC (8.6 per thousand) and 1 case of infection in PICC (1.2 per thousand). For CVC the indwelling time was (19.74 ± 2.14) d, in which the infected CVC’s indwelling time was (13.87 ± 1.56) d; For PICC the indwelling time was (30.41 ± 3.58) d and the infection indwelling time was on the 28th. Logistic regression analysis showed that the catheter indwelling time was the only predictor of CVC infection (P = 0.013). Conclusion: Shortening the indwelling time of CVC, using PICC instead of CVC may reduce CRBSI for long-term-stay patients in ICU.