氯己定醇皮肤消毒液在预防导管相关血流感染中的效果研究  

Effect of chlorhexidine skin disinfectant on prevention of catheter-related bloodstream infections

作　　者：吴晓琴[1] 李兰云[1] 郭晶[2] 何金[1] 李琳[1] 徐莉[1] 杜永川[1] 

机构地区：[1]徐州医学院第二附属医院感染管理科,江苏徐州221006 [2]浙江医学高等专科学校护理专业,浙江杭州310053

出　　处：《中华医院感染学杂志》2014年第21期5312-5314,共3页Chinese Journal of Nosocomiology

基　　金：徐州科技情报局基金资助项目(XF10C031)

摘　　要：目的探讨2%葡萄糖酸氯己定(CHG)醇皮肤消毒液对预防经外周静脉导入中心静脉置管(PICC)导管相关血流感染(CRBSI)的消毒效果。方法对2013年1-12月行PICC置管的肿瘤患者进行前瞻性随机对照研究,将64例PICC置管的患者进行随机分组,观察组34例使用2%CHG醇进行皮肤消毒,对照组30例使用5%聚维酮碘进行皮肤消毒,分别于各组患者进行PICC置管前及置管后48h对置管周围部位的皮肤采样,进行细菌监测并比较两组间的差异。结果观察组在PICC置管前和置管后较对照组48h皮肤菌落数低、干燥时间短(P<0.05),观察组总置管日2 356d,无CRBSI发生;对照组总置管日1 970d,CRBSI 4例,2%CHG醇消毒液能降低CRBSI的发生率(P<0.05)。结论 2%CHG醇皮肤消毒液可降低PICC导管相关血流感染的发生率,并可减少皮肤表面的暂居菌,抑制其生长从而降低CRBSI风险。OBJECTIVE To explore the effect of 2% chlorhexidine gluconate （CHG） on prevention of peripherally inserted central venous catheter-related bloodstream infections .METHODS The prospective randomized control study was conducted for the tumor patients who underwent PICC from Jan 2013 to Dec 2013;the 64 PICC patients were randomly divided into the observation group with 34 cases and the control group with 30 cases , the observation group was treated with 2% CHG for skin disinfection ,while the control group was given 5% povidone iodine for skin disinfection .The skins around the catheter insertion sites were respectively sampled before the PICC catheterization and at 48 hours after the PICC catheterization ;the bacterial species were monitored and compared between the two groups .RESULTS The bacterial colony counts in the skin were less in the observation group than in the control group before and after the PICC catheterization ,and the drying time of the observation group was shorter than that of the control group （P〈 0 .05） .The total catheter indwelling duration of the observation group was 2 356 days , the control group 1 970 days;the catheter-related bloodstream infections occurred in none of the patients in the observation group and 14 cases in the control group . The 2% CHG disinfectant could reduce the incidence of catheter-related bloodstream infections （P〈0 .05） .CONCLUSION The 2% CHG skin disinfectant can reduce the incidence of PICC-related bloodstream infections , decrease the temporarily living flora on the skins , and inhibit their growth so as to reduce the risk of catheter-related bloodstream infections .

关 键 词：氯己定醇 皮肤消毒剂 外周中心静脉置管 导管相关血流感染 肿瘤患者 

分 类 号：R181.32[医药卫生—流行病学]