更换敷料不同频率对新生儿PICC导管穿刺口感染的影响  

Study in influence of frequency of dressing change on PICC insertion site infection in neonates

作　　者：林真珠 蒋玉蓉 刘映辉 简增娇 金丽 吴本清 

机构地区：[1]暨南大学第二临床医学院深圳市人民医院新生儿科,518020

出　　处：《中国实用护理杂志（中旬版）》2010年第8期49-51,共3页Chinese Journal of Practical Nursing

基　　金：深圳市科技计划立项项目（200903008）

摘　　要：目的 探讨敷料不同更换频率对新生儿PICC导管穿刺口感染情况的影响,为选定适合新生儿的敷料更换频率提供理论依据.方法 对95例实施PICC的新生儿进行前瞻性研究,随机分为3组,分别每3,5,7 d更换敷料,观察穿刺口感染情况并进行病原学检测,同时观察与敷料更换有关的并发症发生情况.结果 每3d更换敷料组患儿31例,发生穿刺口感染3例占9.68%,每5 d更换敷料组患儿34例,发生穿刺口感染2例占5.88%,每7 d更换敷料组患儿30例,发生穿刺口感染5例占16.67%,3组穿刺口感染率比较无显著差异.10例穿刺口感染患儿的病原学检测8例阳性,阳性率80%,均为表皮葡萄球菌,其中2例为耐甲氧西林表皮葡萄球菌.每3 d更换敷料组患儿中4例出现表皮撕脱,每5,7 d更换敷料组患儿未出现表皮撕脱.结论 建议新生儿PICC导管每7 d更换敷料1次,敷料潮湿、松动时及时更换.Objective To explore the relationship between frequency of dressing change and PICC insertion site infection in neonates. Methods A prospective study was undertaken. 95 neonates were randomized into 3 groups, group 1 changed dressing every 3 days, group 2 changed dressing every 5 days, group 3 changed dressing every 7 days. Insertion site infection was observed and underwent pathogenic detection,complications associated with dressing change were also observed in all the 3 groups. Results 31 neonates were randomized to group 1 ,there were 3（9.68%）episodes of insertion site infection,34 neonates were randomized to group 2,there were 2（5.88%）episodes of insertion site infection, 30 neonates were randomized to group 3, there were 5（16.67%）episodes of insertion site infection. Rates of insertion site infection did not differ in the 3 groups.8 strains of staphylococcus epidermidis（2 of them were methicillin resistant staphylococcus epidermidis）were founded in 10 neonates who developed insertion site infection,positive rate was 80%. Skin excoriation occurred in 4 of 31 neonates in group 1,no neonates in the other two groups developed skin excoriation. Conclusions We suggest change dressing of neonatal PICC every 7 days,replace dressing if the dressing becomes damp or loosened at any time.

关 键 词：新生儿 经外周导人中心静脉置管 敷料更换 穿刺口感染 

分 类 号：R730.53[医药卫生—肿瘤]