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目的通过对ICU患者导管相关医院感染的情况开展目标性监测,分析危险因素,采取集束干预措施,降低ICU患者医院感染率。方法采用前瞻性目标性监测方法对2013年1月至2015年12月,入住ICU的2334例患者进行目标性监测,填写统一调查表;将2013年1月至2014年6月1140例患者作为对照组(干预前),未实施集束干预措施;将2014年7月至2015年12月1194例患者作为观察组(干预后),采取导管相关感染集束干预措施,观察两组发生导管相关性感染情况,进行对比分析;本文采用SPSS19.0统计软件进行统计分析。结果对照组留置导管总天数为2871天,发生医院感染71例,感染率为24.73‰,其中呼吸机相关性肺炎(VAP)发病率为36.56‰,导尿管相关泌尿道感染(CAUTI)发病率为32.70‰,血管导管相关性血流感染(CRBSI)发病率为6.09‰;观察组留置导管总天数为3075天,发生医院感染44例,感染率为14.31‰,其中呼吸机相关性肺炎发病率为26.06‰,导尿管相关泌尿道感染发病率为13.96‰,血管导管相关性血流感染发病率为3.97‰,较对照组明显降低(P<0.05)。结论相关导管的使用是增加ICU医院感染的危险因素,采取一系列集束干预措施,可减少感染的危险因素,有效预防医院感染的发生,降低ICU医院感染发生率。
Objective To monitor the risk of hospital-related hospital infection in ICU patients, analyze the risk factors, and take cluster interventions to reduce the hospital infection rate in ICU patients. Methods A prospective and targeted surveillance method was used to monitor 2334 patients admitted to the ICU between January 2013 and December 2015. The questionnaire was completed and a unified questionnaire was filled in. From January 2013 to June 2014, 1140 patients were used as control (Before intervention), no cluster intervention was carried out; 1194 patients from July 2014 to December 2015 were taken as the observation group (after intervention), and the catheter-related infection cluster intervention was used to observe the incidence of catheter-related infection , For comparative analysis; This article uses SPSS19.0 statistical software for statistical analysis. Results The total number of catheters in control group was 2871 days, with 71 cases of nosocomial infection, the infection rate was 24.73 ‰. The incidence of ventilator-associated pneumonia (VAP) was 36.56 ‰. The incidence of catheter-related urinary tract infection (CAUTI) Was 32.70 ‰, the incidence of vascular catheter-related bloodstream infection (CRBSI) was 6.09 ‰; the total number of catheter indwelling catheter observation group was 3075 days, 44 cases of hospital infection, the infection rate was 14.31 ‰, of which the incidence of ventilator-associated pneumonia 26.06 ‰. The incidence of catheter-related urinary tract infection was 13.96 ‰, and the incidence of vascular catheter-related bloodstream infection was 3.97 ‰, which was significantly lower than that of the control group (P <0.05). Conclusion The use of related catheters is a risk factor for increasing ICU nosocomial infection. A series of cluster interventions can reduce the risk of infection, effectively prevent nosocomial infections and reduce the incidence of ICU nosocomial infections.