查詢結果分析
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題 名 | 中心靜脈導管使用及其相關感染之調查=Risk Factors for Central Venous Catheter-Related Infection--A Prospective Analysis |
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作 者 | 賴伊貞; 王拔群; 黃政華; | 書刊名 | 院內感染控制雜誌 |
卷 期 | 10:4 2000.08[民89.08] |
頁 次 | 頁233-244 |
分類號 | 419.38 |
關鍵詞 | 中心靜脈導管; 導管相關之感染; 糖尿病; 導管使用日數; 全靜脈營養液; 外科手術部位感染; Central venous catheter; Catheter-associated infection; Diabetes mellitus; Duration of catheterization; Total parenteral nutrition; Surgical site infection; |
語 文 | 中文(Chinese) |
中文摘要 | 近年來由於醫療技術的進步及病患疾病嚴重度的增加,使用中心靜脈導管的頻率亦上升。為了解本院中心靜脈導管的使用情形及相關的感染情形,進行一項前瞻性之調查研究。本調查收集期間為民國八十七年六月至九月共四個月,在本院內外科病房及加護單位中之病患中心靜脈導管使用情形,並找出與感染相關之危險因子,以期減少感染之發生。本次調查共收集249位病患使用中心靜脈導管,367 支中心靜脈導管,2081 個導管日。將所有可能與感染相關之因子以 multiple logistic reqression 作統計分析,找出相關之危險因子。結果發現和中心靜脈導管感染有關之危險因子為:病患有糖尿病、導管使用日數、病患使用全靜脈營養液 (totalparenteral nutrition,TPN)、接受手術、合併外科手術部位感染;其中導管使用日數是影響感染的重要因素。經由統計發現,使用日數在七日以內者,其感染率隨使用日數增加而上升,而使用日數在七日以上者,感染率並未隨使用日數再增加而有所改變。由於本院以往規定中心靜脈導管必須每七日更換,目前則建議:中心靜脈導管不需使用時應立即拔除,不再強調應每七日更換,並強調單位護理人員應每日仔細評估病患注射部位,如注射部位有發生紅、腫、壓痛或病患有不明原因之發燒時應立即拔除;對於使用TPN之病患應加強中心靜脈導管的監控。 |
英文摘要 | The need for central venous catheter is increasing because of the advanced medical technology and increasing severity of patients' illnesses. We conducted a prospective surveillance of the use of the central venous catheter and analyzed the risk factors of catheter- related infections. All central venous catheters employed in our hospital from June to September, 1998 and all possible related risk factors of these patients were analyzed by the multiple logistic regression analysis. Totally, 249 patients, 367 catheters and 2081 catheter-days were enrolled. The significant independent risk factors associated with central venous catheter-related infections were found to include: diabetes mellitus, the use of catheter for total parenteral nutrition, duration of catheterization, patients with surgical procedures, and the evidence of surgical site infection. The infection rate increased as the duration of the indwelling catheter usage is prolonged in the first seven days, but did not change thereafter. We suggest that the central venous catheter be placed only as long as indicated; and there is no need to replace the catheter every seven days. Daily inspection and examination of the insertion site is necessary. If there is any sign of catheter-related infection, e.g., erythema and tenderness, or fever with- out an obvious source, the catheter should be removed immediately. |
本系統中英文摘要資訊取自各篇刊載內容。