透明敷料不同更换频率对新生儿中心静脉导管相关性感染的影响  

Effect of transparent dressings replacing in different frequency on neonatal central venous catheter-related infections

作　　者：凌其英[1] 舒辉[1] 陈虹[1] 唐敏[1] 金夕辉[1] 

机构地区：[1]四川省医学科学院四川省人民医院新生儿重症监护室,四川成都610072

出　　处：《中华医院感染学杂志》2016年第19期4532-4534,共3页Chinese Journal of Nosocomiology

基　　金：四川省卫生厅基金资助项目(130220)

摘　　要：目的探讨新生儿经外周静脉置入中心静脉导管(PICC)后,透明敷料不同更换频率对导管感染发生的影响,为透明敷料选取合适的更换频率提供理论依据。方法选取2012年6月-2015年6月在医院接受留置PICC导管的450例新生儿为研究对象,按照随机的方式将其平均分成3组,其中Ⅰ组每3d更换一次敷料,Ⅱ组每5d更换一次敷料,Ⅲ组每7d更换一次敷料,分析比较3组新生儿导管相关感染的发生。结果 450例新生儿中共有21例发生导管口感染,感染率为4.67%;3组新生儿病原菌检出均以表皮葡萄球菌最多,分别占57.14%、71.42%、49.99%,其次为肺炎克雷伯菌,分别占42.86%、14.29%、16.67%;发生导管相关的血液感染,Ⅰ、Ⅱ组感染率均为0.67%,Ⅲ组未发生导管相关的血流感染。结论建议新生儿中心静脉导管的敷料更换频率为每7天1次,减少医护人员的工作量,降低医院感染率,敷料出现潮湿、松动等现象时,应及时更换。OBJECTIVE To investigate neonatal peripherally inserted central catheter（PICC）,and effect of transparent dressings replacing in different frequency on neonatal central venous catheter-related infections,in order to select the appropriate transparent dressing change frequency to provide a theoretical basis.METHODS A total of450 neonates indwelling PICC catheter in hospital from Jun.2012 to Jun.2015 were selected as research subjects,in a random manner patients were divided into three groups,in which groupⅠ dressing changed once every three days,group Ⅱonce every five days,group Ⅲ once every 7days,the catheter-related infection were analyzed and compared in three groups of children.RESULTS A total of 21 cases of patients got infections from 450 patients,and the infection rate was 4.67%;Staphylococcus epidermidis were the top bacteria detected out from the three groups of children,accounting for 57.14%,71.42%and 49.99%respectively,followed by Klebsiella pneumoniae,accounting for 42.86%,14.29% and 16.67% respectively.The incident rates of catheter-related infection in groupⅠand Ⅱ both 0.67%,and group Ⅲ had no catheter-related bloodstream infections.CONCLUSION We recommend that the dressing central venous catheters in neonates replacement frequency is 7days/time to reduce the workload of medical staff,reduce the incidence of nosocomial infections,but if dressings appear moist and loose phenomenon happen,the cathether should be replaced.

关 键 词：透明敷料 更换频率 经外周静脉置入中心静脉导管 

分 类 号：R472[医药卫生—护理学]