0.9%氯化钠溶液替代酒精清洁皮肤减少深静脉管MARSI发生的临床研究  

A clinical study of 0.9% sodium chloride solution instead of alcohol to clean the skin and reduce the occurrence of MARSI in deep venous tubes

作　　者：程秋野 沈小云[1] 刘秋容 CHENG Qiuye;SHEN Xiaoyun;LIU Qiurong(Department of Hematology,Pingxiang People's Hospital,Jiangxi Province,Pingxiang,Jiangxi,337000,China)

机构地区：[1]江西省萍乡市人民医院血液科,江西萍乡337000

出　　处：《当代医学》2021年第26期44-46,共3页Contemporary Medicine

基　　金：江西省卫生计生委科技计划(20197296)。

摘　　要：目的探讨深静脉置管患者管道维护中皮肤清洁消毒的最佳模式。方法选取2018年12月至2020年5月于本院血液科深静脉置管(CVC、PICC)需中长期导管维护的患者80例,按信封法随机分为实验组和对照组,各40例。实验组采用0.9%氯化钠溶液+2%葡萄糖酸氯己定清洁消毒皮肤后贴膜,对照组采用75%酒精+2%葡萄糖酸氯己定清洁消毒皮肤后贴膜,比较两组MARSI发生率、皮炎程度及局部皮肤细菌培养结果。结果实验组MARSI发生率为10.00%,低于对照组的35.00%,差异有统计学意义(P<0.05)。实验组皮炎发生轻度3例,中度1例;对照组轻度8例,中度4例,重度2例。两组皮肤清洁消毒后细菌培养菌落数均为0 cfu/cm~2,移除贴膜后实验组菌落数低于对照组,差异有统计学意义(P<0.05)。实验组细菌定值率低于对照组,差异有统计学意义(P<0.05);实验组CRBSI发生率低于对照组,但差异无统计学意义。结论 0.9%氯化钠溶液替代酒精清洁皮肤用于深静脉管道维护,可达到消毒灭菌目的,且有效降低深静脉管道患者MARSI的发生率,在一定程度上降低CRBSI发生率。Objective To explore the best mode of skin cleansing and disinfection in pipeline maintenance for patients with deep venous catheterization. Methods From December 2018 to May 2020, 80 patients with deep venous catheterization(CVC, PICC) in the Department of Hematology of our hospital who needed medium and long-term catheter maintenance were selected and they were divided into experimental group and control group according to envelope method, with 40 cases in each group. The experimental group used 0.9% sodium chloride solution+2% chlorhexidine gluconate to clean and disinfect the skin and paste the film, and the control group used 75% alcohol+2% chlorhexidine gluconate to clean and disinfect the skin and paste the film. The incidence of MARSI, the degree of dermatitis and the results of local skin bacterial culture between the two groups were compared. Results The incidence of MARSI in the experimental group was 10.00%, which was lower than 35.00% in the control group, the difference was statistically significant(P<0.05). There were 3 cases of mild dermatitis and 1 case of moderate dermatitis in the experimental group;8 cases of mild dermatitis, 4 cases of moderate and 2 cases of severe dermatitis in the control group. The number of bacterial culture colonies after skin cleaning and disinfection in the two groups was 0 cfu/cm2. After removing the film, the number of colonies in the experimental group was lower than that in the control group, and the difference was statistically significant(P<0.05). The rate of bacterial identification in the test group was lower than that of the control group, and the difference was statistically significant(P<0.05);the incidence of CRBSI in the test group was lower than that of the control group, but the difference was not statistically significant. Conclusion Physiological saline replaces alcohol to clean the skin for deep venous pipeline maintenance, which can achieve the purpose of disinfection and sterilization. At the same time, it can effectively reduce the incidence of MA

关 键 词：0.9%氯化钠溶液 替代 酒精 深静脉管道 MARSI 

分 类 号：R472[医药卫生—护理学]