氯己定体表清洗对RICU患者医院感染的影响  

Impact of chlorhexidine whole-body washing on nosocomcial infections in RICU patients

作　　者：于洪涛[1] 卢滨[1] 贾金广 郭彩霞[1] 杜鹃[1] 聂丽娟[1] 李飞[1] 

机构地区：[1]郑州人民医院呼吸与危重症医学科,河南郑州450003

出　　处：《中华医院感染学杂志》2013年第15期3700-3702,共3页Chinese Journal of Nosocomiology

基　　金：河南省卫生厅科技攻关项目(2011030017)

摘　　要：目的探讨氯己定体表清洗对呼吸重症监护室(RICU)患者医院感染的影响,以降低RICU的医院感染发生率。方法选取2010年4月-2012年3月郑州人民医院RICU收治的患者为研究对象,将2010年4月-2011年3月入住的112例患者作为对照组,2011年4月-2012年3月入住的130例患者作为氯己定组,对照组采取标准方法进行治疗,氯己定组采用氯己定全身清洗法进行治疗,比较两组患者治疗后各项指标的差异。结果氯己定组入院时、24、48、72h的皮肤病原菌定植率分别是9.23%、13.85%、7.69%、7.69%;氯己定组24、48、72h时的皮肤病原菌新发生率分别是11.54%、4.62%、6.36%;氯己定组24、48、72h时皮肤病原菌清除率分别是75.00%、66.67%、70.00%;入院及前3d皮肤定植病原菌构成为金黄色葡萄球菌占52.0%、奇异变形菌占26.0%、鲍氏不动杆菌占12.0%、铜绿假单胞菌占2.0%;氯己定组呼吸机相关性肺炎发生率为1.76%,而对照组为1.90%;导管相关性血流感染的发生率下降了0.4%,导管相关性尿路感染的发生率下降了0.33%。结论使用氯己定可有效地清除皮肤定植菌,值得在临床推广应用。OBJECTIVE To explore the impact of chlorhexidine whole-body washing on the incidence of nosocomial infections in the patients of respiratory intensive care unit （ RICU ） so as to reduce the incidence of nosocomial infections in the RICU. METHODS The patients who admitted to the RICU of the Zhengzhou People＇s Hospital from Apr 2010 Mar 2011 were enrolled in the study, totally 112 patients, who were treated between Apt 2010 and Mar 2011 ,were chosen as the control group, and 130 patients who were treated between Apt and Mar 2012 were selected as the chlorhexidine group. The control group was treated by using the standard method, and the ehlorhexidine group was treated with chlorhexidine whole-body washing, then the indicators after the treatment were compared between the two groups. RESULTS The colonization rates of pathogens in the skin on admission, 24 hours, 48 hours, and 72 hours were respectively 9. 23%, 13. 85%, 7.69%, and 7.69% in the chlorhexidine group; the incidence rates of pathogens in the skin at 24 hours, 48 hours, and 72 hours after the treatment were respectively 11.54%, 4.62%, and 6.36% in the chlorhexidine group; the clearance rates of pathogens in skin at 24 hours, 48 hours, and 72 hours after the treatment were 75.00%, 66.67%, and 70.00% in the chlorhexidine group. The constituent ratios of the pathogens colonized in the skin on the admission and 3 days before treatment were in turn as follows： Staphylococcus aureus （52.0%）, Proteus mirabilis （26.0%）, Acinetobacter baurnannii （12.0%）, and Pseudomonas aeruginosa （2. 0%） . The incidence of ventilator-associated pulmonary infections was 1.76% in the chlorhexidine group, 1.90% in the control group; the incidence of the catheter-related blood stream infections dropped by 0.4%, and the incidence of the catheter-related urinary tract infections dropped by 0.33%. CONCLUSION The chlorhexidine can effectively remove the bacteria colonized in the skin, it is worth promoting in clinical practice.

关 键 词：氯己定 呼吸机相关性肺炎 导管相关性血流感染 

分 类 号：R187[医药卫生—流行病学]