52例化疗病人中心静脉导管感染初步调查  

A Preliminary Research of 52 Chemotherapy Patients with Central Vein Catheter(CVC) Infection

作　　者：姜慧[1] 朱惠芳 武军[1] 

机构地区：[1]南京市肿瘤医院,江苏南京210029

出　　处：《实用护理杂志》2000年第6期33-34,共2页Journal of Practical Nursing

摘　　要：对需要化疗的肿瘤病人 ,行中心静脉导管 (CVC)置管并经此反复给药 ,是一种减轻病人痛苦、方便治疗的常用诊疗技术 ,但CVC感染往往伴有菌血症 ,时常因病情严重而治疗困难。 5 2例CVC置管化疗引起实际感染率为14 6 % ,其原因 :一是抗肿瘤药杀伤白细胞 ,使机体的免疫功能下降 ;二是置管时间较长 ,创口处理不当 ,细菌经导管漫延扩散而致菌血症 ;其三是晚期肿瘤病人长期卧床抗感染能力下降。因此 ,对CVC感染除针对性使用大剂量抗生素外 ,加强护理也是降低感染率的重要措施之一。护理内容包括 :(1)在化疗期间密切监测病人白细胞的变化 ,对白细胞显著下降者应使用升白细胞的药物 ;(2 )定期消毒处理创口周围皮肤和外露导管 ,更换覆盖无菌敷料 ,一般隔日 1次 ,天气炎热 ,每日 1次 ;(3)每日进行病室紫外线照射和空气消毒 ;(4 )协助病人多下床运动 。It is a pain-alleviating and convenient medical technology for tumor patients requiring chemotherapy to put CVCs for repeatedly infusing drugs.However,CVC infection is usually accompanied with bacteremia and the therapy often becomes difficult because of exacerbation.The actual infection rate of 52 chemotherapy cases by CVCs is 14.6%.The reasons included:(1)Anti-tumor drugs killed white blood cells (WBC) and organis's immunologic function was down\|regulated.(2)The period for putting CVCs was too long and the treatment of openings of wound was incorrect so bacteria diffused by catheter and incurred bacteria.(3)Late tumor patients were laid up in bed for a long time and organism's anti-infusion ability was down-regulated.Hence,it is one of the important measures for CVC infusion to strengthen nursing care besides directly applying massive antibiotic.Nursing care content includes:(1)Closely watching patient's WBC change during chemotherapy periods and applying leukogenic drugs for serious WBC fall patients.(2)Periodically sterilizing peripheral skin of opening of wound and outside catherter,and coving and changing sterile dressing for one time every two days or one time everyday when it is hot.(3)Irradiating wards with ultraviolet ray and sterilizing air everyday.(4)Helping patients to get up and do sports to strengthen organism's antiinfectionability.

关 键 词：肿瘤 化疗 中心静脉导管置管 感染 护理 

分 类 号：R73-31[医药卫生—肿瘤]