抗生素封管预防血透患者临时中心静脉留置导管相关感染的研究  

Use of an antimicrobial lock solution for prevention of the catheter related infections in hemodialysis patients with temporary central vein catheter

作　　者：刘仕艳[1] 汤颖[1] 李荣英[1] 

机构地区：[1]复旦大学附属中山医院血液净化中心,200032

出　　处：《齐齐哈尔医学院学报》2008年第9期1112-1115,共4页Journal of Qiqihar Medical University

摘　　要：目的评价抗生素封管对中心静脉留置导管相关感染的预防作用,探讨感染控制的有效措施。方法选择113例临时中心静脉留置导管的血透患者,随机分为两组:对照组53例采用单纯肝素封管(肝素组);实验组60例采用肝素+头孢唑啉联合封管(抗生素组)。随访两组导管相关感染的发病率并使用卡方检验进行比较。同时将肝素组和本血透中心既往中心静脉导管相关性感染的发病率进行比较。结果感染共7例次,总体感染发病率为6.19%,其中肝素组3例次,感染发病率为5.66%,抗生素组4例次,感染发病率为6.67%,两组的发病率无显著性差别(P>0.05)。肝素组和既往中心静脉导管相关性感染的发病率(17.94%)有显著差异(P<0.05)。结论加用头孢唑啉封管对中心静脉留置导管相关感染的发病无明显预防作用;严格无菌操作和加强护理是降低感染、减少抗生素使用的关键措施。Objective To identify the efficacy of antimicrobial solution [or preventing the catheter related infections in hemodilysis patients with temporary central vein catheter and search for the better control methods. Methods One hundred-thirteen patients with new temporary hemodialysis catheters were enrolled into the study ,and were randomly assigned to receive either heparin lock solution （heparin 50mg/ml） or antimicrobial lock solution （cefazolin 10mg/ml,heparln45mg/ml）, patients were followed up, Data analysis was performed with 2-tailed Fisher＇exact test, meanwhile, the previous catheter related infection incidence was contrasted with the heparin group. Results Seven patients developed infections. Total infection incidence was 6.19 %. there of fifty--three patients in the heparin group（5.66 %）, four of sixty patients in the cefazolin group（6.67 % ）, no significant differences （P 〉 0.05）. Infection incidence in the heparin group was significant different with the previous （17.94%） （P 〈 0.05）. Conclusions Antimicrobial lock solutions were not the standard heparin lock alone in the prevention of catheter related infections. Keeping the rules of sterile operation and improving nursing work might reduce the infections.

关 键 词：抗生素封管 导管相关感染 中心静脉留置导管 血液透析 

分 类 号：R183.9[医药卫生—流行病学] R472.9[医药卫生—公共卫生与预防医学]