本文關(guān)鍵詞： 中心靜脈導(dǎo)管 導(dǎo)管相關(guān)血流感染 集束化干預(yù)策略 惡性血液病　出處：《川北醫(yī)學(xué)院學(xué)報(bào)》2017年02期 　論文類型：期刊論文

【摘要】：目的:探討中心靜脈導(dǎo)管集束化干預(yù)策略(central line bundle,CLB)對惡性血液病患者導(dǎo)管相關(guān)性血流感染(catheter related bloodstream infection,CRBSI)的影響效果。方法:參照美國健康促進(jìn)會(huì)(Institution for Healthcare Improvement,IHI)中心靜脈導(dǎo)管相關(guān)血流感染預(yù)防的集束化干預(yù)策略,制定CRBSI集束化干預(yù)辦法,選擇2010年1月至2015年1月在本院留置中心靜脈導(dǎo)管行常規(guī)護(hù)理的252例惡性血液病患者作為對照組,隨機(jī)選取同期在我院留置中心靜脈導(dǎo)管行集束化干預(yù)策略的271例惡性血液病患者作為實(shí)驗(yàn)組,對常規(guī)護(hù)理與集束化干預(yù)策略后的效果進(jìn)行比較性分析。結(jié)果:對照組股靜脈GRBSI平均發(fā)生率最高,達(dá)26.1‰,集束化干預(yù)策略后股靜脈置管GRBSI平均發(fā)生率7.4‰,對照組股靜脈GRBSI平均發(fā)生率較實(shí)驗(yàn)組比較差異有統(tǒng)計(jì)學(xué)意義(P0.01),對照組頸內(nèi)靜脈、鎖骨下靜脈置管GRBSI平均發(fā)生率較實(shí)驗(yàn)組比較差異無統(tǒng)計(jì)學(xué)意義(P0.05);對照組與實(shí)驗(yàn)組的CRBSI發(fā)生率分別為13.5‰、6.1‰,集束化干預(yù)策略后實(shí)驗(yàn)組的CRBSI率(‰)、CRBSI起始時(shí)間、留置天數(shù)、住院時(shí)間和費(fèi)用及手消毒劑消耗量與對照組比較差異均有統(tǒng)計(jì)學(xué)意義(P0.01);CRBSI以革蘭陽性菌為主,集束化干預(yù)策略后實(shí)驗(yàn)組與對照組的病原菌構(gòu)成比比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:采用集束干預(yù)策略可有效降低惡性血液病患者中心靜脈導(dǎo)管相關(guān)性血流感染發(fā)生率,縮短患者住院時(shí)間,降低住院費(fèi)用,減輕患者經(jīng)濟(jì)負(fù)擔(dān),提高了惡性血液病患者的生存率和生活質(zhì)量。
[Abstract]:Objective: to investigate the effect of central line bundle intervention strategy on catheter-related related bloodstream infection in patients with malignant hematological diseases. Methods: referring to the for Healthcare improvement of the American Association for the Promotion of Health (AHA), the central venous catheters were used to treat the patients with malignant hematological diseases. Cluster intervention strategies for the prevention of related blood stream infections, To establish CRBSI cluster intervention, 252 patients with malignant hematological diseases were selected as control group, who were treated with central venous catheter in our hospital from January 2010 to January 2015. 271 patients with malignant hematopathy were randomly selected as experimental group. Results: the average incidence of femoral vein GRBSI was the highest in the control group (26.1 鈥，

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