水胶体敷料预防中心静脉导管细菌定植和细菌感染的效果  

Effect of hydrocolloid dressing on the prevention of bacterial colonization and infection in central venous catheter

作　　者：许祖存 胡新春 王申[2] 李静[2] 齐华英[2] XU Zu-cun;HU Xin-chun;WANG Shen;LI Jing;QI Hua-ying(Tianjin First Central Hospital,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院普通外科,天津300192 [2]天津市第一中心医院护理部,天津300192

出　　处：《中华医院感染学杂志》2019年第24期3822-3825,共4页Chinese Journal of Nosocomiology

基　　金：天津市医药科技攻关计划基金资助项目(2017zh89)

摘　　要：目的探讨水胶体敷料预防中心静脉置管(Central venous catheters,CVCs)细菌定植和细菌感染的作用。方法选取2015年8月-2017年12月天津市第一中心医院普通外科的440例住院患者作为研究对象,根据随机数字表格法分为对照组和试验组各220例。对照组患者在行CVCs后以3M敷料实施导管固定,试验组患者在接受CVCs后以水胶体敷料开展导管固定。同时对比分析两组患者的导管病原菌定植、导管相关性感染(Catheter-related infections,CRIs)、导管相关性血源性感染(Catheter-related bloodstream infections,CR-BSIs)、皮肤病原菌定植的效果。对比两组敷料的皮肤安全性。结果试验组导管相关性感染率及导管相关性血源性感染率低于对照组(P<0.05)。试验组与对照组1~9 CFUs/板的例数无统计学差异,10~99 CFUs/板、≥100 CFUs/板、皮肤病原菌定植发生总数及Lg(B)低于对照组(P<0.05)。两种敷料使用后皮肤异常情况相比,差异无统计学意义。结论在神经外科中心静脉患者中,采用水胶体敷料有利于降低细菌定植以及细菌感染,且其皮肤安全性较高。OBJECTIVES The effect of water gel dressing on bacterial colonization and prevention of bacterial infection in patients with central venous catheter was analyzed. METHODS A total of 440 hospitalized patients from August 2015 to December 2017 in general surgery department of Tianjin First Central Hospital were enrolled in the study. By using the random number table method, 220 patients were divided into the control group and 220 patients were divided into the experimental group. The control group was treated with 3 M dressing after central venous catheterization, whereas the experimental group was treated with hydrocolloid dressing after central venous catheterization. The incidence of catheter-related infections(CRIs), catheter-related bloodstream infections(CR BSIs) and skin pathogens colonization were compared between the two groups. The skin safety of the dressing in the two groups was also evaluated. RESULTS Compared with 3 M transparent dressing, hydrocolloid dressing can effectively reduce the rate of catheter-related infection and catheter-related blood-borne infection(P<0.05). There was no significant difference in the number of 1-9 CFUs/plates between the two groups. The number of 10~99 CFUs/plates, ≥100 CFUs/plates, the total number of skin pathogenic bacteria colonization and Lg(B) in the experimental group were significantly lower than that in the control group(P<0.05). There was no significant difference in skin abnormalities between the two dressings. CONCLUSION Hydrocolloid dressing is beneficial to reduce bacterial colonization and infection in the patients with central vein of neurosurgery and can be used with high skin safety.

关 键 词：水胶体敷料 3M敷料 中心静脉导管 病原菌定植 导管相关性感染 血源性感染 

分 类 号：R472[医药卫生—护理学]