造血干细胞移植患者导管感染的相关因素分析与护理对策  

Analysis on the related factors and nursing strategies of patients with catheter infection during hematopoietic stem cell transplantation

作　　者：陶俊[1] 张诚[1] 杜欣[1] 张曦[1] 曾荔[1] 肖韶连 孙爱华[1] 

机构地区：[1]第三军医大学新桥医院血液科全军血液病中心,重庆400037

出　　处：《中国输血杂志》2016年第10期1108-1110,共3页Chinese Journal of Blood Transfusion

摘　　要：目的分析造血干细胞移植患者进行PICC或CVC置管导致导管感染的原因,并总结有效的预防护理措施。方法患者于造血干细胞移植前行PICC或CVC置管,并给予规范化的观察与护理。当患者体温≥37.5℃时,予以从导管和外周静脉同时抽血做定量血培养,导管和外周静脉血培养都呈阳性,并为同一微生物时,确定导管感染。结果 245例患者中13例发生导管感染,发生率5.3%,12例患者拔出了导管,1例患者根据药敏实验结果,积极治疗后,感染得到控制。结论造血干细胞移植患者在处于粒缺状态时,必需采取积极有效的护理措施。当导管感染发生后,应及时拔出导管并根据药敏实验给予积极治疗。Objective To analyze the factors and nursing strategies for patients with catheter infection during hematopoi- etie stem cell transplantation （HSCT） and summarize the effective nursing measures for prevention. Methods The patients received PICC or CVC catheter before HSCT. The normative observation and nursing care were performed. When the patient body temperature was higher than or equal to 37. 5, blood samples will be drawn from the catheter and peripheral vein for quantitative blood culture; if the blood cultures are positive for the same microorganism, catheter infection was affirmed. Re- suits The catheter infection occurred in 13 cases of 245 patients （5.3%）. The catheters were pulled out and 1 patient was healed after an active treatment based on the experimental results of antimicrobial susceptibility. Conclusion Effective and preventive nursing measures are needed for patients undergoing HSCT with agranulocytosis. The catheter should be pulled out, and the drugs should be given according to the drug sensitivity test.

关 键 词：造血干细胞移植 导管感染 护理 

分 类 号：R457.1[医药卫生—治疗学]