预冲式导管冲洗器预防患儿导管相关性血流感染的临床研究  

Clinical effect of prefilled catheter flush device on prevention of catheter-related bloodstream infections in children

作　　者：高静[1] 伊亚敏[1] 刘亚平[1] 曹卫国[1] 许晓丽[1] 黄蕊[1] 戴兰芬[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》2016年第2期441-443,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预防作用,为降低医院感染提供依据。方法选取2014年1-12月400例因肺炎住院患儿,将患儿随机分为试验组和对照组,每组各200例,试验组采用预冲式导管冲洗器冲封管,对照组采用普通注射器生理盐水脉冲式正压冲封管,比较两组患儿医院感染率、不良事件发生率,并分析医院感染病原菌分布;采用SPSS21.0软件进行统计分析。结果 400例患儿共有27例发生医院感染,医院感染率6.75%,其中试验组5例,感染率2.50%,对照组22例,感染率11.00%,试验组医院感染率显著低于对照组,差异有统计学意义(χ2=5.739,P<0.05);27例感染患儿共分离出31株病原菌,其中革兰阳性菌20株占64.5%,革兰阴性菌8株占25.8%,真菌3株占9.7%;试验组导管内血栓形成率显著低于对照组(P<0.05),两组间局部渗血、意外脱管等不良事件发生率比较差异无统计学意义。结论静脉留置针改善血栓形成及不良事件发生优于传统方法,采用预冲式导管冲洗器能够显著降低住院患儿医院感染率。OBJECTIVE To explore the clinical effect of prefilled catheter flush device on prevention of nosocomial infections in hospitalized children so as to reduce the incidence of nosocomial infections.METHODS A total of 400 children with pneumonia who were hospitalized from Jan 2014 to Dec 2014 wee enrolled in the study and randomly divided into the experimental group and the control group,with 200 cases in each.The experimental group was treated with prefilled catheter flush device for tube sealing,while the control group was treated with normal saline syringe for pulsed positive pressure tube sealing.The incidence rates of nosocomial infections and adverse events were observed and compared between the two groups of children,the distribution of pathogens causing the nosocomial infections was analyzed,and the statistical analysis was performed with the use of SPSS21.0software.RESULTS Of 400 children,27had nosocomial infections with the infection rate of 6.75%,including 5（2.50%）cases in the experimental group and 22（11.0%）in the control group;the incidence rate of nosocomial infections of the experimental group was significantly lower than that of the control group,（χ2=5.739,P〈0.05）.Totally31 strains of pathogens were isolated from the 27 children with infections,including 20（64.5%）strains of grampositive bacteria,8（25.8%）strains of gram-negative bacteria,and 3（9.7%）strains of fungi.The rate of catheter thrombosis of the experimental group was significantly lower than that of the control group（P〈0.05）;there was no significant difference in the incidence of adverse events such as local bleeding and unexpected extubation between the two groups.CONCLUSIONThe venous indwelling needle is superior to the conventional method in the improvement of thrombosis and prevention of adverse events;the prefilled catheter flush device can significantly reduce the incidence of nosocomial infections in the hospitalized children.

关 键 词：预冲式导管冲洗器 医院感染 静脉留置针 病原菌 

分 类 号：R181.32[医药卫生—流行病学]