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老年患者中心静脉置管感染的防治对策

ISSN号：1005-4529
期刊名称：《中华医院感染学杂志》
时间：0
分类：R181.32[医药卫生—流行病学;医药卫生—公共卫生与预防医学]
作者机构：[1]广西桂林医学院附属医院护理部,广西桂林541001, [2]广西桂林医学院附属医院放疗科,广西桂林541001, [3]广西桂林医学院附属医院肿瘤内科,广西桂林541001, [4]广西桂林医学院附属医院老年内科,广西桂林541001
相关基金：广西卫生厅重点科研基金资助项目（重2011016）

关键词：老年患者, 中心静脉置管, 经外周穿刺, 经锁骨下静脉穿刺, 感染, Elderly patient, Central venous catheter, Peripherally inserted central catheter, Subclavian vein puncture, Infection

中文摘要：

目的比较老年患者经外周静脉穿刺中心静脉置管（Peripherally Inserted Central Catheters,PICC）与经锁骨下静脉穿刺行中心静脉置管（Central Venous Catheter,CVC）的感染发生率,并探讨其防治对策。方法选取200例PICC和140例CVC的老年患者为观察对象,分别为PICC组200例和CVC组140例,比较两组患者置管成功率、穿刺部位和导管相关性血流感染发生情况。结果患者一次置管成功率PICC组为100.0%,CVC组为86.43%,两组比较差异有统计学意义（χ2=28.75,P〈0.05）;穿刺部位感染PICC组患者7例,感染率为3.50%,CVC组患者感染31例,感染率为22.14%,发生导管相关性血流感染PICC组患者1例,发生率为0.50%,CVC组患者15例,发生率为10.71%,两组比较差异均有统计学意义（χ2=19.61,P〈0.05）。结论老年患者经外周静脉穿刺中心静脉置管安全、有效,穿刺部位和导管相关性血流感染等并发症发生率较低,可减轻患者痛苦。

英文摘要：

OBJECTIVE To compare with the incidence of peripherally inserted central catheter （PICC）-associated infections and the incidence of subclavian vein puncture central venous catheter （CVC）-assoeiated infections and explore the prevention countermeasures. METHODS Totally 200 elderly patients of PICC and 140 elderly patients of CVC were enrolled in the study and divided into the PICC group with 200 cases and the CVC group with 140 cases, then the success rate of intubation, puncture sites, and incidence of catheter-related bloodstream infections were observed and compared between the two groups. RESULTS The success rate of initial intubation was 100.0% in the PICC group, 86.43% in the CVC group, and there was significant difference（x2 =28.75 ,P〈0.05）. There were 7 （3.50%） cases of puncture site infections in the PICC group and 31 （22.14%） cases in the CVC group. The catheter-associated bloodstream infections occurred in 1 case in the PICC group with the incidence rate of 0.50% and in 15 cases in the CVC group with the incidence rate of 10.71%, and there was significant difference between the two groups（x2 = 19.61, P〈0.05）. CONCLUSION The PICC is safe and effective for the elderly patients; the incidence of complications such as the puncture site infections and catheter-associated infections is low, which may contribute the relief of the patients＇ sufferings.

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