本文選題：機(jī)械通氣　切入點(diǎn)：中心靜脈導(dǎo)管　出處：《中華醫(yī)院感染學(xué)雜志》2017年20期

【摘要】：目的探究行機(jī)械通氣中心靜脈導(dǎo)管發(fā)生中心靜脈導(dǎo)管相關(guān)性血流感染(CRBSI)患者的肺功能及病原菌分布和耐藥性。方法選取2012年8月-2016年12月于醫(yī)院接受治療的52例行機(jī)械通氣留置中心靜脈導(dǎo)管發(fā)生CRBSI患者列為感染組,同時(shí)選取同時(shí)期在醫(yī)院治療的58例相同未發(fā)生CRBSI患者列為未感染組。分析感染組患者感染的病原菌分布及主要菌群對(duì)常用抗菌藥物的藥敏結(jié)果,對(duì)比兩組患者肺功能的相關(guān)指標(biāo)。結(jié)果感染組52例患者共分離病原菌60株,其中革蘭陽(yáng)性菌39株占65.00%,以表皮葡萄球菌及金黃色葡萄球菌為主,革蘭陰性菌21株占35.00%,以肺炎克雷伯菌及大腸埃希菌為主。藥敏結(jié)果顯示,革蘭陽(yáng)性菌對(duì)青霉素、慶大霉素、阿奇霉素等的耐藥率較高,最高為100.00%,對(duì)萬(wàn)古霉素較敏感;革蘭陰性菌對(duì)阿莫西林、妥布霉素及慶大霉素等耐藥率較高,最高為100.00%,對(duì)亞胺培南較敏感。感染組患者肺功能指標(biāo)肺活量(FVC)、第1秒呼氣容積(FEV1)及FEV1/FVC分別為(1.99±0.28)L、(3.19±0.21)L、(49.12±6.54)%顯著低于未感染組(2.36±0.31)L、(3.45±0.63)L、(54.21±6.89)%(P0.05)。結(jié)論 CRBSI會(huì)導(dǎo)致行機(jī)械通氣中心靜脈導(dǎo)管患者肺功能下降,建議采用嚴(yán)格遵守?zé)o菌操作原則等防治措施,早期降低患者感染風(fēng)險(xiǎn)。
[Abstract]:Objective to investigate the pulmonary function, pathogenic bacteria distribution and drug resistance in patients undergoing mechanical ventilation with central venous catheter associated blood stream infection (CRBSII). Methods 52 patients treated in hospital from August 2012 to December 2016 were selected. Patients with CRBSI caused by mechanical ventilation indwelling central venous catheter were classified as infection group. At the same time, 58 patients with the same CRBSI who were treated in hospital at the same time were selected as the uninfected group. The distribution of pathogenic bacteria and the susceptibility of the main bacteria to common antimicrobial agents in the infected group were analyzed. Results 60 strains of pathogenic bacteria were isolated from 52 patients in the infection group, of which 39 strains were Gram-positive bacteria, mainly Staphylococcus epidermidis and Staphylococcus aureus. There were 21 Gram-negative strains (35.00%), mainly Klebsiella pneumoniae and Escherichia coli. The drug sensitivity of Gram-positive bacteria to penicillin, gentamicin and azithromycin was higher, the highest was 100.00,sensitive to vancomycin. Gram-negative bacteria have higher resistance to amoxicillin, tobramycin and gentamicin. The highest value was 100.00g, which was more sensitive to imipenem. The vital capacity of lung function in the infected group was 1.99 鹵0.28 L (FEV1) and FEV1/FVC was 1.99 鹵0.28, respectively, which was significantly lower than that in the uninfected group (49.12 鹵6.54 鹵2.36 鹵0.31). Conclusion CRBSI can induce the decrease of pulmonary function in the patients with mechanical ventilation central venous catheter, and the lung function of the infected patients is significantly lower than that of the uninfected group (P < 0.01). Conclusion the lung function of the patients undergoing mechanical ventilation with central venous catheter is significantly lower than that of the uninfected group (2.36 鹵0.31). Conclusion the lung function of the patients undergoing mechanical ventilation with central venous catheter is significantly lower than that of the uninfected group (P < 0.05). It is suggested that strict adherence to the principle of aseptic operation and other preventive measures should be adopted to reduce the risk of infection in patients at an early stage.
【作者單位】： 南陽(yáng)醫(yī)學(xué)高等�？茖W(xué)校第一附屬醫(yī)院重癥醫(yī)學(xué)科;
【基金】：河南省科技廳計(jì)劃基金資助項(xiàng)目(122300410330)
【分類號(hào)】：R459.7

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 黃一鳴,楊海燕,楊旅軍,陳雄斌;抗感染與普通中心靜脈導(dǎo)管的比較研究[J];臨床麻醉學(xué)雜志;2004年01期

2 劉莉華;中心靜脈導(dǎo)管置管的護(hù)理體會(huì)[J];當(dāng)代護(hù)士(學(xué)術(shù)版);2005年06期

3 翟啟娟;劉春榮;韓妮;;中心靜脈導(dǎo)管固定技巧[J];齊魯護(hù)理雜志;2006年08期

4 ;使用經(jīng)皮中心靜脈導(dǎo)管中的問(wèn)題[J];九江醫(yī)學(xué);1994年04期

5 唐劉紅,王明賢;減少中心靜脈導(dǎo)管中細(xì)菌繁殖的兩種方案比較[J];新醫(yī)學(xué);2000年03期

6 楊中華 ,周錫芳;中心靜脈導(dǎo)管的應(yīng)用及其護(hù)理[J];國(guó)外醫(yī)學(xué).護(hù)理學(xué)分冊(cè);2001年10期

7 王秀華,李玲,馬鳳蓮,馬清華;中心靜脈導(dǎo)管在引流中的應(yīng)用體會(huì)[J];現(xiàn)代護(hù)理;2001年11期

8 劉艷紅,郭芳;中心靜脈導(dǎo)管的應(yīng)用及護(hù)理[J];齊魯護(hù)理雜志;2002年11期

9 丁玲 ,張晶 ,王宜民;關(guān)于使用中心靜脈導(dǎo)管的須知[J];國(guó)外醫(yī)學(xué).護(hù)理學(xué)分冊(cè);2003年09期

10 李學(xué)芹,王信U，

本文編號(hào)：1693792