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目的调查恶性肿瘤患者导管相关性血流感染发生情况及其相关因素,为制定防控措施提供依据。方法采用前瞻性调查的方法,对本医院住院实施中心静脉置管恶性肿瘤患者血流感染情况进行了调查。结果2008年全年住院801例中心静脉置管恶性肿瘤患者发生血流感染69例,日感染率为3.8‰,例数感染率为8.6%。引起恶性肿瘤患者血流感染的主要危险因素有抗肿瘤治疗、侵袭性操作、抗生素的使用以及血管内留置导管时间等。选用适宜导管并尽早拔除、加强穿刺技术的规范性、无菌隔离技术、合理使用抗生素和强化局部护理等措施,可有效降低感染率。结论恶性肿瘤病人血管留置导管血流感染诱发因素主要是侵袭性操作、抗肿瘤药物应用以及置管时间等,可通过加强导管技术和无菌隔离技术以及正确护理得到有效控制。
Objective To investigate the incidence of catheter-related bloodstream infections in patients with malignant tumors and its related factors, and to provide evidence for the development of prevention and control measures. Methods A prospective investigation was conducted to investigate the prevalence of bloodstream infection in hospitalized patients with central venous catheter malignancy. Results Of the 801 hospitalized patients with central venous malignancies in 2008, 69 cases were infected with bloodstream infection. The daily infection rate was 3.8 ‰ and the number of cases was 8.6%. The main risk factors causing bloodstream infections in patients with malignant tumors are anti-tumor therapy, invasive procedures, the use of antibiotics, and intravascular catheterization time. Selection of suitable catheters and early removal, to enhance the normative puncture technique, aseptic isolation techniques, rational use of antibiotics and intensive care and other measures can effectively reduce the infection rate. Conclusion The predisposing factors of blood flow indwelling catheter in patients with malignant tumor are mainly invasive operation, antitumor drug application and catheterization time, which can be effectively controlled by strengthening the catheterization technique, aseptic isolation technique and correct nursing.