小儿心脏术后中心静脉导管感染的相关因素分析

发布时间：2018-02-27 12:03

本文关键词： 感染中心静脉导管先心病心脏手术相关因素　出处：《新疆医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：中心静脉导管在心脏外科术中及术后应用广泛。中心静脉导管直接与心脏及血液循环相通，管理不善可导致致病菌直接入血。本文研究先天性心脏病外科手术后中心静脉导管相关感染、菌群分布的情况以及导管相关感染的危险因素，为临床科学管理中心静脉导管，降低导管相关感染的发生率提供可靠参考。方法：连续抽取从2010年1月～2011年12月两年内手术的334例先心病患儿留置的中心静脉导管进行尖端细菌培养加药敏。结果：334例中心静脉导管共培养出43株病原菌，导管相关感染发生率为12.87%。最常见的病原菌是鲍曼不动杆菌，革兰氏阴性杆菌药敏结果显示-内酰胺类的氨苄西林耐药率最高。革兰氏阳性球菌药敏结果显示：红霉素是耐药率最高的抗生素。随着拔管时间的延长，导管相关感染发生率多组之间的比较差异有统计学意义（P＜0.01）。随着体外循环转流时间的延长，，导管相关感染发生率整组之间的比较差异有统计学意义（P＜0.01），说明导管相关感染发生率随着体外循环转流时间的延长有明显的升高趋势。结论：中心静脉导管作为一个重要的致病菌来源，应加强无菌操作观念，尽量缩短留置时间，同时降低导致中心静脉相关的各种危险因素。早期诊断、及时合理应用抗生素，以减少中心静脉导管长期留置所带来的不良后果。
[Abstract]:Objective: central venous catheter used in cardiac surgery and postoperatively. The central venous catheter directly with the heart and blood circulation is interlinked, can lead to bacteria directly into the blood of poor management. The research of central venous catheter related infection after surgery for congenital heart disease, the bacteria distribution and catheter-related infection risk factors and for clinical management of central venous catheter, reduce the incidence of catheter related infection and provide reliable reference. Methods: from January 2010 to December 2011 two years of continuous extraction surgery within 334 cases of children with congenital heart disease in the heart of indwelling venous catheter tip bacterial culture. Results: 334 cases of central venous catheter were isolated from 43 strains of pathogenic bacteria the incidence of catheter-related infection, the most common pathogens of 12.87%. Bauman Acinetobacter, gram negative bacilli susceptibility results showed the lactam ammonia Ampicillin resistance rate of gram positive cocci. Drug susceptibility results showed that erythromycin is the highest rate of antibiotic resistance. With the extension of time to extubation, catheter-related infection rate had significant difference between the groups (P < 0.01). With the extension of the cardiopulmonary bypass time, catheter related infection was statistically the significance of differences between the whole group (P < 0.01), indicating the incidence of catheter-related infection with prolonged CPB time increased significantly. Conclusion: the central venous catheter as an important source of pathogenic bacteria, should strengthen the concept of aseptic operation, shorten the indwelling time, while reducing the risk of various causes the related factors of central venous. Early diagnosis, timely and reasonable use of antibiotics, in order to reduce the central venous catheter indwelling the adverse consequences.

【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R726.5

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