葡萄糖酸氯已定醇预防血液透析中心静脉导管相关感染的研究  

Research on the prevention of chlorhexidine digluconate ethanol skin disinfectant for central venous catheter-related infections in hemodialysis patients

作　　者：谭庆[1] 廖小平[1] 孙煦勇 雷志影 TAN Qing LIAO Xiao - ping SUN Xu - yong LEI Zhi - ying(The 303 Hospital of PLA,Nanning Guangxi 530021 1 Guangxi Key Laboratory for Transplantation Medicine Institute, Chin)

机构地区：[1]解放军第303医院,广西南宁530021 [2]移植医学研究院广西重点实验室

出　　处：《中国消毒学杂志》2016年第12期1160-1161,1164,共3页Chinese Journal of Disinfection

基　　金：中华医院感染控制研究基金(ZHYG2014-0007)

摘　　要：目的研究葡萄糖酸氯己定醇对血液透析中心静脉导管相关感染的预防效果。方法选择148例留置静脉导管并行血液透析治疗的患者,随机分为实验组和对照组各74例,分别采用20 g/L葡萄糖酸氯己定乙醇溶液和5 000 mg/L的碘伏皮肤消毒液进行穿刺部位消毒和相关护理消毒,比较两组患者及其不同置管部位和置管时间的感染率。结果实验组和对照组感染率分别为10.8%和23.0%。颈内静脉置管组和股静脉置管组感染率分别为11.1%和23.9%,其中实验组感染率分别为9.8%和12.1%,对照组感染率分别为12.5%和35.3%。置管留置时间两周以下,总体感染率为9.4%,实验组和对照组感染率分别为7.1%和11.1%;置管留置时间两周及两周以上,总体感染率提高到19.0%,实验组和对照组感染率分别为11.7%和26.8%。结论采用葡萄糖酸氯己定醇进行血液透析患者中心静脉导管相关感染的防控,其效果优于碘伏。Objective To investigate the prevention effect of chlorhexidine digluconate ethanol skin disinfectant on central venous catheter-related infections in hemodialysis patients. Methods A total of 148 cases of hemodialysis patients with central venous catheter were enrolled in the study and were randomly divided into the experimental group and the control group.The patients in the experimental group were disinfected by 2% chlorhexidine digluconate ethanol skin disinfectant,while the patients in the control group were disinfected by iodine volts during the process of the treatment and nursing. Then we compared the infection rates between the two groups and different catheter sites and catheterization time. Results The central venous catheter-related infections in the experimental group was 10. 8% and in the control group was 23. 0%. The infection rate of the internal jugular vein group was 11. 1% and the femoral vein group was 23. 9%,respectively. The infection rate of the experimental group was 9. 8% and 12. 1%,and the infection rate of the control group was 12. 5% and 35. 3%. When the duration of indwelling catheter was inside two weeks,the overall infection rate was 9. 4% and the infection rates of experimental group and control group were 7. 1% and 11. 1% respectively. When the duration of indwelling catheter was two weeks or more,the overall infection rate increased to 19. 0% and the experimental group and the control group infection rates were11. 7% and 26. 8% respectively. Conclusion The prevention and control effect of chlorhexidine digluconate ethanol for hemodialysis patients with central venous catheter-related infection is better than that of iodine volts.

关 键 词：氯己定醇 碘伏 皮肤消毒剂 血液透析 中心静脉导管相关感染 

分 类 号：R187.2[医药卫生—流行病学]