三通回血降低血透深静脉导管感染因素的探讨  

The investigation of infection factors of three-junction placement in blood dialysis deep vein indwelling catheter

作　　者：徐武敏[1] 谷禾[1] 吴瑶瑶[1] 叶霞[1] 叶白如[1] 金领微[1] 

机构地区：[1]浙江省温州医科大学附属第二医院血液净化中心,325000

出　　处：《中华全科医学》2015年第5期763-765,共3页Chinese Journal of General Practice

摘　　要：目的探讨利用"三通"连接管回血对血液透析深静脉留置导管患者的疗效及安全性。方法选取温州医科大学附属第二医院血液透析深静脉留置导管患者86例,随机分为2组,观察组(n=43)采用三通连接管回血,对照组(n=43)采用改良式回血,分别观察2组患者回血结束时化验室结果、回血法残留血量、生理盐水用量、滤器凝血状况,观察18个月,每6个月检查C反应蛋白(CRP)、记录感染发生率,并进行统计学分析。结果 2组化验室结果回血法残留血量、生理盐水用量、滤器凝血状况差异均无统计学意义(P>0.05)。观察组CRP(mg/L)0个月、6个月、12个月、18个月分别为5.527±4.649、5.552±4.560、6.444±4.241、6.327±5.146,对照组CRP(mg/L)0个月、6个月、12个月、18个月分别为5.879±4.718、8.193±6.847、9.876±8.772、8.897±5.820,2组比较差异有统计学意义(P<0.05);观察组感染率0个月、6个月、12个月、18个月分别为0%、4.65%(2/43)、6.97%(3/43)、9.30%(4/43),对照组0个月、6个月、12个月、18个月分别为0%、11.63%(5/43)、13.95%(6/43)、18.60%(8/43),2组比较差异有统计学意义(P<0.01)。结论利用三通连接管回血能有效降低血液透析深静脉留置导管患者感染危险性,且无不良反应。Objective To explore efficacy and safety of using three-junction placement in hemodialysis patients with deep vein indwelling catheter. Methods Select 86 patients with deep vein indwelling catheter,they were randomly divided into two groups,the observation group（ n = 43） using three-junction placement,the control group（ n = 43） using the improved and observation of 18 m,6 m per check c-reactive protein（ CRP） and record the infection incidence for statistical analysis. The two groups of patients at the end of the lab results,blood residual volume,dosage of normal saline,and filter blood coagulation state were recorded,respectively. Results Two groups of laboratory results residual volume,the dosage of normal saline,filter blood coagulation conditions had no statistical difference（ P〉0. 05）. Observation group of CRP（ mg /L） 0 m,6 m,12 m,18 m were 5. 527 ± 4. 649,5. 552,6. 444 ± 4. 241,4. 241 4. 560 ± 5. 146 and control group of CRP（ mg/L） 0 m,6 m,12 m,18 m were 5. 879 ± 4. 718,8. 193,9. 876 ± 8. 772,8. 772 6. 847 ± 5. 820 comparison was statistically significant（ P〈0. 05）. Observation group infection rate 0 m,6 m,12 m and 18 m were 4. 65%（ 2 /43）,6. 97%（ 3 /43）,9. 30%（ 4 /43） and control group 0 m,6 m,12 m and 18 m were 11. 63%（ 5 /43）,13. 95%（ 6 /43）,18. 60%（ 8 /43）,the difference was statistically significant（ P〈0. 01）. Observation group of CRP（ mg / L） 0 m,6 m,12 m and 18 m were 5. 527 ± 4. 649,5. 552,6. 444 ± 4. 241,4. 241 4. 560 ± 5. 146 and control group CRP（ mg / L） 0 m,6 m,12 m and 18 m were 5. 879 ± 4. 718,8. 193,9. 876 ± 8. 772,8. 772 6. 847 ± 5. 820,the difference was statistically significant（ P〈0. 05）. Observation group infection rate 0 m,6 m,12 m and 18 m were 4. 65%（ 2 /43）,6. 97%（ 3 /43）,9. 30%（ 4 /43）and control group 0 m,6 m,12 m and 18 m were 11. 63%（ 5 /43）,13. 95%（ 6 /43）,18. 60%（ 8 /43）,the difference was statistically significant（ P〈0. 01）. Conclusion Placement blood return me

关 键 词：三通连接管 血液透析 深静脉导管 感染 

分 类 号：R459.5[医药卫生—治疗学]