肝素与抗菌药物封管预防中心静脉导管感染的临床对比研究  

Comparative study of clinical effects of heparin and antibiotics sealed tubes on prevention of central venous catheter-associated infections

作　　者：王红[1] 邓孝陵[1] 李小杰[1] 童峥慧 

机构地区：[1]华中科技大学同济医学院附属普爱医院肾内科,湖北武汉430033

出　　处：《中华医院感染学杂志》2015年第7期1590-1592,共3页Chinese Journal of Nosocomiology

基　　金：湖北省卫生厅重点基金资助项目(HW-2011C10129)

摘　　要：目的探讨肝素与抗菌药物封管预防血液透析患者中心静脉导管感染不同临床效果,以寻找最佳的方法,提高临床诊治水平。方法选取2010年2月-2014年1月70例中心静脉导管患者为研究对象,分为对照组35例,予单纯肝素封管;观察组35例,给予肝素与抗菌药物混合液封管,其余治疗相同,观察治疗后临床效果,数据采用SPSS16.0进行统计分析。结果中心静脉导管感染率对照组为22.85%、观察组为5.72%,并发症总发生率对照组为20.00%、观察组为2.86%,置管时间对照组为(58.9±17.8)d、观察组为(50.3±15.3)d,两组比较差异均有统计学意义(P<0.05);两组感染患者检出病原菌均以金黄色葡萄球菌、链球菌属和肺炎克雷伯菌为主。结论抗菌药物封管可降低血液透析患者中心静脉导管感染的发生,其并发症较低。OBJECTIVE To explore the clinical effects of heparin and antibiotics sealed tubes on prevention of central venous catheter-associated infections in the patients undergoing hemodialysis so as to seek the optimal method and improve the clinical treatment.METHODS A total of 70 patients who underwent central venous catheterization from Feb 2010 to Jan 2014 were recruited as the study objects and divided into the control group with 35 cases and the observation group with 35 cases.The control group was treated with single heparin sealed tube,while the observation group was treated with antibiotics sealed tube,and other treatments were the same.The clinical effects were observed after the treatments,and the statistical analysis was performed with the use of SPSS16.0software.RESULTS The incidence of central venous catheter-associated infections was 22.85%in the control group,5.72%in the observation group;the total incidence of complications was 20.00%in the control group,2.86%in the observation group;the catheter indwelling time was（58.9±17.8）days in the control group,（50.3±15.3）days in the observation group,and there was statistically significant difference between the two groups（P〈0.05）.The Staphylococcus aureus,Streptococcus spp,and Klebsiella pneumoniae were the predominant pathogens isolated from the patient with infections in the two groups.CONCLUSIONThe antibiotics sealed tube can reduce the incidence of central venous catheter-associated infections in the patients undergoing hemodialysis,with the incidence of complications lower.

关 键 词：肝素 抗菌药物 封管 血液透析 中心静脉导管 感染 

分 类 号：R181.32[医药卫生—流行病学]