预冲式导管冲洗对住院患儿医院感染的影响  

Impact of pre-filled flush device of catheters on nosocomial infections in hospitalized children

作　　者：高静[1] 褚丽敏[1] 邓永敏[1] 王立娜[1] 李云[1] 伊亚敏[1] 王静[1] 

机构地区：[1]河北医科大学第一医院儿科,河北石家庄050031

出　　处：《中华医院感染学杂志》2015年第14期3331-3332,3335,共3页Chinese Journal of Nosocomiology

基　　金：河北省卫生厅科研基金资助项目(ZL20140163)

摘　　要：目的探讨预冲式导管冲洗器对住院患儿医院感染的影响,旨在降低静脉留置针输液患儿医院感染的发生率。方法选取2014年1-12月400例采用静脉留置针输液肺炎患儿,将其随机分为观察组与对照组,每组各200例;观察组采用BD福徕喜预充式导管冲洗器进行封管,对照组采用传统的生理盐水进行封管,分析静脉留置针输液发生医院感染的影响因素和病原菌分布。结果观察组患儿的堵管率和感染率均为0,显著低于对照组的16.0%和10.0%,差异有统计学意义(P<0.05);对照组20例感染患儿共分离出28株病原菌,其中革兰阴性菌16株占57.1%,革兰阳性菌10株占35.7%,真菌2株占7.2%;多因素logistic回归分析结果显示,静脉留置针留置时间>5d和传统冲、封管方法是患儿医院感染的危险因素。结论采用静脉留置针输液主要感染病原菌为革兰阴性菌,预冲式导管冲洗器可以有效预防采用静脉留置针输液的住院患儿的医院感染发生率。OBJECTIVE To explore the impact of the pre-filled flush device of catheters on nosocomial infections in the hospitalized children so as to reduce the incidence of nosocomial infections in the children undergoing the venous indwelling needle infusion.METHODS A total of 400 children with pneumonia who underwent the venous indwelling needle infusion from Jan 2014 to Dec 2014 were enrolled in the study and randomly divided into the observation group and the control group,with 200 cases in each.The observation group was treated with Fu Lai Xi prefilled flush device of catheters of BD for tube sealing,while the control group was treated with the conventional normal saline for tube sealing.The influencing factors for the nosocomial infections in the children undergoing the venous indwelling needle infusion and the distribution of pathogens were observed.RESULTS The rate of tube plugging of the observation group was 0,significantly lower than 16.00% of the control group;the infection rate of the observation group was 0,significantly lower than 10.0% of the control group（P〈0.05）.Totally 28 strains of pathogens have been isolated from 20 children with infections in the control group,including 16（57.1%）strains of gram-negative bacteria,10（35.7%）strains of gram-positive bacteria,and 2（7.2%）strains of fungi.The multivariate logistic regression analysis indicated that the indwelling time of venous indwelling needle more than 5days and conventional flush tube sealing method were the risk factors for the nosocomial infections in the children.CONCLUSIONThe gram-negative bacteria are dominant among the pathogens causing the infections in the children undergoing the venous indwelling needle infusion.The pre-filled flush device of catheters can effectively prevent the nosocomial infections in the hospitalized patients undergoing the venous indwelling needle infusion.

关 键 词：预冲式导管冲洗器 患儿 医院感染 静脉留置针 

分 类 号：R181.3-2[医药卫生—流行病学]