预防烧伤患者中心静脉导管相关性血流感染的范围综述  

Scoping review on prevention of central venous catheter-related bloodstream infection in burn patients

作　　者：陈丽娟[1] 刘丽红[1] 孙林利 陈娜娜 孟美芬[1] Chen Lijuan;Liu Lihong;Sun Linli;Chen Nana;Meng Meifen(Department of Burns,the Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China)

机构地区：[1]昆明医科大学第二附属医院烧伤科,650101

出　　处：《中华烧伤杂志》2021年第10期970-977,共8页Chinese Journal of Burns

基　　金：云南省卫生科技计划(2017NS292,2018NS0309);昆明医科大学2020年硕士研究生创新基金(2020S206)。

摘　　要：目的了解预防烧伤患者中心静脉导管相关性血流感染(CRBSI)的研究趋势及范围。方法采用范围综述的方法。以“中心静脉导管、烧伤、感染”,“central venous catheter、infection、catheter-related bloodstream infection、burn”为检索词进行预检索,在预检索的基础上制订不同的检索式,检索《中国知网》《万方数据库》《维普中文期刊数据库》和《PubMed》《Embase》《CINAHL》《Cochrane Library》中关于烧伤患者中心静脉CRBSI的研究,检索时限均为建库至2020年8月。对纳入的文献进行数据提取,包括第1作者、研究发表时间、研究国家、研究类型、中心静脉CRBSI诊断依据和干预措施、研究样本选择、感染相关发生率、研究结论。结果本研究共纳入20篇文献。第1作者来自中国、美国、阿根廷,发表时间为1990—2020年,研究类型包括随机对照试验、类实验性研究、病例对照研究、队列研究及实施性研究。纳入的文献对烧伤患者中心静脉CRBSI的诊断依据不统一,包括采用《美国疾病预防控制中心指南》与《医院感染诊断标准》以及未指明出处的其他诊断标准。干预措施包括使用抗生素涂层导管、乙醇浸渍的导管端口保护帽等新型材料,多学科合作及综合性预防措施等。纳入的文献中样本量均较少,样本选择不同,包括患者数和中心静脉导管置管次数。纳入的文献中针对感染的结局指标呈多样化,国内对照组患者中心静脉CRBSI千日感染率为20.41‰~29.1‰,国外对照组患者中心静脉CRBSI千日感染率大部分<16.6‰,而采取相应的干预措施后患者中心静脉CRBSI发生率均有不同程度降低。相关研究结论为新型材料、多学科合作以及综合性预防措施对预防烧伤患者中心静脉CRBSI有较好的效果。结论国内预防烧伤患者中心静脉CRBSI的研究起步早、研究类型多样,烧伤患者中心静脉CRBSI的诊断标准不统一,�Objective To investigate the research trend and scope of prevention of central venous catheter-related bloodstream infection(CRBSI)in burn patients.Methods The scoping review method was adopted.Pre-retrieval was carried out with search terms of"中心静脉导管,烧伤,感染"and"central venous catheter,infection,catheter-related bloodstream infection,burn".On the basis of pre-retrieval,different retrieval formulas were formulated to retrieve researches related to central venous CRBSI in burn patients in China National Knowledge Internet,Wanfang Database,VIP Database,PubMed,Embase,CINAHL,and Cochrane Library from the establishment of each database to August 2020.Data were extracted from the included literature,including the first author,research publication time,research country,research type,diagnosis basis and intervention measures of central venous CRBSI,research sample selection,incidence related to infection,and research conclusion.Results A total of 20 randomized controlled trials,quasi-experimental studies,case-control studies,cohort studies,and implementation researches published in 1990-2020 were included in this study with the first authors from China,the United States of America,or Argentina.The diagnostic bases for central venous CRBSI in burn patients were not uniform in the included literature,including adopting the Guidelines of American Centers for Disease Control and Prevention,Diagnostic Criteria for Nosocomial Infection,and other diagnostic criteria without specifying the source.The intervention measures included the use of new materials such as antibiotics coated catheter and ethanol impregnated port protectors,multidisciplinary cooperation,and comprehensive preventive measures.The sample size in the included literature was small,and the sample selection was different,including the number of patients and the the number of placement of central venous catheter.The outcome indicators for infection in the included literature were diversified.The incidence per 1000 days of central venous CRBSI was

关 键 词：烧伤 中心静脉导管 导管相关性血流感染 范围综述 

分 类 号：R644[医药卫生—外科学] Q256[医药卫生—临床医学]