不同皮肤消毒剂对层流室造血干细胞移植患者中心静脉导管消毒效果比较  

Comparison of the disinfection effects of different skin disinfectants on central venous catheter in immune-deficient patients

作　　者：胡伟[1] 郭秀娟[1] 宋岩 徐晓东[1] 王婷[1] 曹艳超[1] 颜霞[1] Hu Wei;Guo Xiujuan;Song Yan;Xu Xiaodong;Wang Ting;Cao Yanchao;Yan Xia(Institute of Hematology,the People′s Hospital,Peking University,Beijing 100044,China)

机构地区：[1]北京大学人民医院血液科,北京大学血液病研究所,国家血液系统疾病临床医学研究中心造血干细胞移植北京市重点实验室,100044

出　　处：《中国实用护理杂志》2020年第8期579-582,共4页Chinese Journal of Practical Nursing

基　　金：北京大学人民医院研究与发展基金(RDN2015-09)。

摘　　要：目的 探讨2种皮肤消毒剂2%葡萄糖酸氯己定醇溶液与0.5%碘伏消毒液对免疫功能低下患者的中心静脉导管(CVC)维护的效果。方法 选取2016年1月1日至2017年8月31日于北京大学人民医院血液科层流病房接受治疗的患者180例为研究对象。按照随机数字表法分为试验组和对照组各90例。试验组采用2%葡萄糖酸氯己定醇皮肤消毒剂维护CVC,对照组采用0.5%碘伏消毒液维护CVC。每周换药1次,连续维护3周,根据导管处伤口情况换药,并记录每次换药原因及每次换药所需时间,分析2组患者的导管维护时间、换药原因、换药间隔天数及导管伤口不良反应发生情况。结果 试验组的皮肤待干时间和护士换药时间分别为(0.62±0.10)、(11.67±0.33)分钟,对照组分别为(1.97±0.18)、(14.48±0.33)分钟,2组比较差异有统计学意义(t值为63.044、57.296,P<0.01),2组在换药间隔天数、CVC导管伤口不良反应发生情况方面比较差异无统计学意义(P>0.05)。结论 2%葡萄糖酸氯己定醇与0.5%碘伏消毒液在免疫功能低下患者CVC导管维护中均有良好的皮肤消毒效果,并且使用2%葡萄糖酸氯己定醇的皮肤待干时间更短、护士换药时间更短,有利于提高护理工作效率,值得在临床护理工作中推广。Objective To compare the effect of the 2% chlorhexidinegluconate disinfectant and 0.5%iodophor disinfectant on the maintenance of central venous catheter(CVC)in patients with immunodeficiency.Methods The patients were randomly divided into two groups.2%chlorhexidinegluconate disinfectant was used in the experimental group,and 0.5%iodophor disinfectant was used in the control group.The CVC was sterilized once a week and continuously maintained for 3 weeks.According to the condition of catheter,the dressing was changed in time in case of any problem,and the reason and time for the catheter nursing care were recorded.The duration of changing the catheter dressing in different disinfectant,incidence rate of dressings looseness and incidence of catheter-related infections in two groups were analyzed.Results The duration of skin drying and duration of caring in the experimental group were(0.62±0.10)min,(11.67±0.33)min,significantly shorter than the control group[(1.97±0.18)min,(14.48±0.33)min](t values were 63.044,57.296,P<0.01).In term of the adverse effects on CVC,there were no statistical differences between two groups(P>0.05).Conclusions Both 2%chlorhexidinegluconate and 0.5% iodophor disinfectant have similar disinfection effect on CVC caring,but 2% chlorhexidinegluconate disinfection is more efficient and worthy of application in clinical settings.

关 键 词：葡萄糖酸氯己定醇 碘伏 造血干细胞移植 中心静脉导管 

分 类 号：R47[医药卫生—护理学]