导管的管理与导管相关性感染率的关系研究  

Correlation between management of catheters and incidence of catheter-associated infections

作　　者：宋秀婵[1] 唐艳琴[2] 宋娟丽[1] 陈素君[1] 

机构地区：[1]广东医学院附属石龙博爱医院ICU [2]广东医学院附属石龙博爱医院 感染管理科,广东东莞523325

出　　处：《中华医院感染学杂志》2014年第18期4480-4482,共3页Chinese Journal of Nosocomiology

基　　金：东莞市医疗卫生科技基金项目(201110515028070)

摘　　要：目的了解导管管理方法与导管相关性感染率的影响关系,通过加强导管管理,降低导管相关性感染率。方法对2010年7月-2012年10月ICU患者留置中心静脉导管相关性感染率与导管管理之间关系进行调查研究,管理方法分两阶段实施,第一阶段2010年7月-2011年6月共81例设为对照组,采取普通换药程序,第二阶段2011年7月-2012年10月共82例设为观察组,观察组采取2%葡萄糖酸氯己定乙醇及氯己定敷贴进行换药。结果观察组导管穿刺部位局部感染率明显低于对照组(P<0.05),观察组CRBSI率比对照组下降了7.2/千导管日;观察组导管相关性感染率低于对照组(P<0.05),两组7d更换敷料导管相关性感染率均明显低于3d更换敷料;两组分别在去除敷料后进行皮肤表面与导管接口表面细菌采样,对照组菌落数明显高于观察组,皮肤表面菌落数与导管输液接口细菌数差异均有统计学意义(P<0.05)。结论使用氯己定敷贴以及减少敷料更换频率、加强对静脉营养后导管管理可有效降低导管相关性感染发生。OBJECTIVE To understand the relationship between the management of catheters and the incidence of catheter-associated infections so as to reduce the incidence of catheter-associated infections .METHODS The pa-tients who underwent the catheter indwelling in ICU from Jul 2010 to Oct 2012 were recruited in the study ,then the relationship between the incidence of central venous catheter-associated infections and the management of cath-eters was observed ,a two-phase trial of the management measures was conducted ,the first phase was from Jul 2010 to Jun 2011 ,with 81 cases involved and set as the control group ,the common dressing change procedures were adopted in the control group ;the second phase was from Jul 2011 to Oct 2012 ,with 82 cases involved and set as the observation group , the 2% chlorhexidine gluconate ethanol and chlorhexidine applicators were used for dressing change in the observation group .RESULTS The incidence of local infections in the catheter puncture sites was significantly lower in the observation group than in the control group （P＆lt;0 .05）;as compared with the con-trol group ,the incidence of CRBSI decreased by 7 .2/thoudand catheter day ;the incidence of the catheter-associat-ed infections of the observation group was lower than that of the control group （P＆lt;0 .05） .The incidence of cathe-ter-associated infections was significant lower on 7-day of dressing change than on 3-day dressing change .The skin surfaces and the catheter interfaces were sampled for the two groups of patients after the removal of dressings ,the bacterial colony counts of the control group were significantly higher than those of the observation group ,and there was significant difference in the bacterial colony counts between the skin surfaces and the catheter interfaces （P＆lt;0 .05） .CONCLUSION It is an effective way to use chlorhexidine applicators ,reduce the frequency of dressing change ,and strengthen the management of catheters after the intravenous nutrition therapy so as to reduce the in-

关 键 词：导管管理 导管相关性感染 氯己定敷贴 

分 类 号：R181.32[医药卫生—流行病学]