重症医学专科资质培训重症医学专科资质培训··标准教材标准教材·2009·2009重症医学专科资质培训工作内容导管相关性感染重症医学专科资质培训重症医学专科资质培训··标准教材标准教材·2009·20092目的•导管相关感染的病原学和感染途径•导管相关感染的定义和诊断原则•导管相关性感染拔管指征•导管相关感染抗生素的选择和疗程•导管相关性感染的预防措施重症医学专科资质培训重症医学专科资质培训··标准教材标准教材·2009·20093病例分析病例分析•女性72岁，正常体重，无吸烟史•因术后肠梗阻性行肠切除术•术中留置锁骨下静脉导管•术后出现发热，胸痛，心电图显示急性非ST段抬高心肌梗死（NSTEMI）转入ICU•外周血培养和中心静脉导管头培养出白色念珠菌•外科手术切口培养无细菌生长。Catheter-relatedsepticthrombophlebitisofthesuperiorvenacavainvolvingtheatrialseptum:acasereportStavrosTzortzis1,StavrosApostolakisetCasesJournal2008,1:272doi:10.1186/1757-1626-1-272辅助检查辅助检查重症医学专科资质培训重症医学专科资质培训··标准教材标准教材·2009·20094Transthoracicechocardiographicimagingofrightatriumandsuperiorvenacava(subcostalview)Transthoracicechocardiographicimagingofrightatriumandsuperiorvenacava(subcostalview)Aroundsolitarylesion,protrudingintotherightatriumisclearlyvisualized(A).ThelesionAroundsolitarylesion,protrudingintotherightatriumisclearlyvisualized(A).Thelesionhasbeendiminished15daysafteranti-fungalandhasbeendiminished15daysafteranti-fungalandanti-thrombotictreatment(B,C).anti-thrombotictreatment(B,C).心彩超提示：2.5×1.5栓子由右心房至上腔静脉，未发现瓣膜赘生物重症医学专科资质培训重症医学专科资质培训··标准教材标准教材·2009·20095Transesophagealechocardiographicimaging-bicavalview-confirmeda2.5×1.5roundsolitaryTransesophagealechocardiographicimaging-bicavalview-confirmeda2.5×1.5roundsolitarylesionwithdistinctivebordersattachedintheSVC,protrudingintotherightatrium(ThicklesionwithdistinctivebordersattachedintheSVC,protrudingintotherightatrium(Thickarrow)arrow)Theecholucentareamarkedwiththethinarrow-mostprobablypresentsanabscessoftheTheecholucentareamarkedwiththethinarrow-mostprobablypresentsa...
