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目的研究新生儿中心静脉置管导管相关感染的发生情况及危险因素。方法采用回顾性调查方法,对2008年12月-2011年12月某医院新生儿重症监护室(NICU)脐静脉置管(UVC)和经外周中心静脉置管(PICC)患儿的临床资料进行分析,分析导管相关性血流感染(CRBSI)的发生率和病原菌构成,探讨其危险因素。结果582例静脉置管患者发生CRBSI 37例,其中PICC组32例,感染率8.1%,为2.79‰导管日;UVC组5例,感染率2.7%,为3.9‰导管日。PICC组的主要致病菌为真菌、凝固酶阴性葡萄球菌和革兰阴性杆菌,UVC组的主要致病菌为真菌和革兰阳性球菌。中心静脉置管并发CRBSI的危险因素为胎龄、出生体重、置管时间和多种侵入性操作。结论胎龄小、出生体质量轻,中心静脉置管时间长及进行多种侵入性操作可造成CRBSI感染率升高。
Objective To study the incidence and risk factors of catheter-related catheterization in neonates. Methods The clinical data of neonatal intensive care unit (NICU) umbilical venous catheter (UVC) and peripheral central venous catheterization (PICC) in a hospital from December 2008 to December 2011 were retrospectively reviewed. Analysis and analysis of the incidence of catheter-related bloodstream infections (CRBSI) and pathogens, and explore the risk factors. Results Of the 582 patients with venous catheterization, 37 patients had CRBSI. Among them, 32 patients were PICC, the infection rate was 8.1%, which was 2.79 ‰ on catheter day. UVC group had 5 cases with infection rate of 2.7% at 3.9 ‰ catheter day. The main pathogenic bacteria in PICC group were fungi, coagulase-negative staphylococcus and gram-negative bacilli. The main pathogens in UVC group were fungi and gram-positive cocci. The risk factors for central venous catheterization complicated with CRBSI were gestational age, birth weight, catheterization time and various invasive procedures. Conclusions Small gestational age, low birth weight, long central venous catheterization and multiple invasive procedures may lead to an increased CRBSI infection rate.