抗菌静脉导管的初步研究  

Preliminary Studies on the Antimicrobial Venous Catheters

作　　者：余於荣[1] 赵英[1] 曹勇[1] 李国辉[1] 王文[1] 吴梅兴 吴燮卿[1] 

机构地区：[1]江西医学院第一附属医院烧伤科,江西南昌330006 [2]江西崇仁县白陴乡卫生院,江西崇仁344204

出　　处：《江西医学院学报》2001年第4期61-64,共4页Acta Academiae Medicinae Jiangxi

摘　　要：目的 :制作抗菌导管 ,预防静脉导管感染。方法 :用洗必尽和医用聚氨酯为主要成份涂覆硅胶胶管制成抗菌导管。抗菌试验包括 :(1)涂覆液MIC测定 ;(2 )体外抗菌作用观察 ;(3)体外抗菌作用持续时间观察 ;(4 )导管加温对抗菌作用的影响 ;(5 )动物试验检测抗菌效果。结果 :涂覆液对金黄色葡萄球菌MIC90 为 8.5 μg/ml、MIC50 为 2 .8μg/ml;对绿脓杆菌MIC90 为 31.3μg/ml、MIC50 为 15 .6 μg/ml;涂覆导管在琼脂培养基中对金黄色葡萄球菌、绿脓杆菌及大肠杆菌产生抑菌圈 ,而未涂覆导管不产生抑菌圈 ;涂覆导管浸泡在金黄色葡萄球菌、绿脓杆菌及大肠杆菌菌悬液中 ,抑菌时间分别为 15 .6± 0 .6d ,3.0± 0 .4d和 3.6± 0 .2d ;涂覆导管高温处理 ,抑菌作用与未高温处理涂覆导管无差异 ;在兔皮下包埋涂覆导管 ,病理检查见管周组织结构清晰 ,炎性渗出物少 ,而未涂覆导管病理检查见组织结构紊乱 ,炎性渗出物多。结论 :实验结果证实涂覆导管有较强抗菌效果 ,对其临床实用价值 。Objective:To investigate the antimicrobial effect of the venous catheters coated with chlorhexidine and polyurethanein which were made in our laboratory.Methods:A series of antimicrobial tests were carried out: (1) Determination of the minimum inhibitory concentration (MIC) of the coating solution; (2) Observation of the antimicrobial activity in vitro; (3) Observation of antimicrobial durability; (4) Observation of the effect of high temperature on antimicrobial activity of the coated catheters; (5) Determination of antimicrobial effect of the coated catheters in experimental animal. Results:The MIC 90 and MIC 50 of the coating solution for saukeus were 8.5 μg/ml and 2.8 μg/ml, respectively, while those for P·aeruginosa were 31.3 μg/ml and 15.6 μg/ml. Again, the coated catheters produced inhibitory zones on the blood agar plates. In contrast, uncoated catheters produced no inhibitory zone. The mean days of antimicrobial activity of the coated catheters against S·aureus, P·aeruginosa, and Escheri Chiacoli were 15.6±0.6, 3.0±0.4, and 3.6±0.2, respectively. Antimicrobial activity of the coated catchers treated with high temperature was not different from that of normal coated catheters. After hidden under rabbit′s skin for 4 days, the histological examination revealed that the subcutaneous tissues around the coated catheters were clear and had less inflammatory substances. In contrast, the tissues around uncoated catheters showed significant pathologic changes with more inflammatory substances. Conclusion: Those results prove that the coated catheter has powerful antimicrobial activity.

关 键 词：医用聚氨酯 抗菌作用 动物实验 抗菌静脉导管 静脉置管 医源性感染 

分 类 号：R608[医药卫生—外科学]