重症监护室中心静脉置管患者发生导管相关性感染的危险因素分析胡健【摘要】目的：探討重症监护室中心静脉置管患者发生导管相关性感染的危险因素及护理对策。方法：回顾性分析2019年1-12月本院重症监护室的504例中心静脉置管患者的临床资料，包含性别、年龄、诊断结果、进入ICU后的APACHE-Ⅱ评分、ICU住院时间、总住院时间、合并症情况等基础资料，以及对可能引起导管相关性感染的危险因素进行分析，包括置管类型、置管部位、置管留置时间、主要理化生化指标等。采用单因素和多因素logistic回归分析中心静脉置管患者导管相关性感染的危险因素。结果：504例患者中有73例患者发生导管相关性感染，感染率为14.48%。感染组与未感染组在入ICU时APACHE-Ⅱ评分、糖尿病史、置管季节、置管类型、置管部位、置管时间、血红蛋白含量偏低、白蛋白含量偏低、操作人员工作年限方面比较，差异均有统计学意义（P<0.05）。logistic回归分析显示夏季置管、操作人员工作年限20分、置管时间>7d是患者导管相关性感染的独立危险因素（P20分、有糖尿病史、夏季置管、操作人员工作年限较短、置管时间>7d是引起重症监护室中心静脉置管患者发生导管相关性感染的独立危险因素，护理过程中应注意提高护理人员操作和护理技术，选择合适置管方式、缩短置管时间是降低导管相关性感染风险的重要措施。【关键词】中心静脉置管导管相关性感染危险因素护理对策RiskFactorsAnalysisofCatheter-relatedInfectioninPatientswithCentralVenousCatheterizationinIntensiveCareUnit/HUJian.//MedicalInnovationofChina，2021，18（12）：-114[Abstract]Objective：Toexploretheriskfactorsandnursingstrategiesofcatheter-relatedinfectioninintensivecareunit（ICU）patientswithcentralvenouscatheterization.Method：Theclinicaldataof504patientswithcentralvenouscatheterizationinICUofourhospitalfromJanuarytoDecember2019wereretrospectivelyanalyzed，includinggender，age，diagnosisresults，APACHE-ⅡscoreafterenteringICU，ICUlengthofstay，totallengthofstay，complicationsandotherbasicdata，aswellastheriskfactorsofcatheter-relatedinfection，includingcathetertype，catheterlocation，indwellingtime，mainphysicalandchemicalindexes，etc.Univariateandmultivariatelogisticregressionwereusedtoanalyzetheriskfactorsofcatheter-relatedinfectioninpatientswithcentralvenouscatheterization.Result：Catheter-relatedinfectionsoccurredin73patientsof504patients，theinfectionratewas14.48%.ComparisonofAPACHE-Ⅱscore，diabeteshistory，catheterizationseason，catheterizationtype，catheterizationposition，catheterizationtime，lowhemoglobincontent，lowalbumincontent，andworkingyearsofoperatorsbetweentheinfectedgroupandtheuninfectedgroupatthetimeofadmissiontoICU，thedifferenceswerestatisticallysignificant（P20points，andcatheterizationtime>7dwereindependentriskfactorsforcatheterizationassociatedinfection（P20points，diabeteshistory，summertubeplacement，shortworkingyearsofoperators，andcatheterizationtime>7dareindependentriskfactorsforcatheter-relatedinfectioninpatientswithcentralvenouscatheterplacementinICU.Inthenursingprocess，attentionshouldbepaidtoimprovetheoperationandnursingtechnologyofnursingstaff，andthechoiceofappropriateplacementmodeandshorteningthetimeofcatheterplacementaretheimportantmeasurestoreducetheriskofcatheter-relatedinfection.[Keywords]CentralvenouscatheterizationCatheter-relatedinfectionRiskfactorsNursingstrategyFirst-authorsaddress：MachengPeoplesHospital，Macheng438300，Chinadoi：10.3969/j.issn.1674-4985.2021.12.026中心静脉置管是一种经皮穿刺锁骨下静脉、颈静脉、股静脉并沿血管走向将导管插至到达中心静脉的方法，由于中心静脉血管直径粗、血流量大，穿刺成功率高，注射...