抗菌敷料预防肺癌化疗致骨髓抑制患者PICC导管相关感染的效果  

Antibacterial dressing for PICC catheter-related infection in lung cancer patients with chemotherapy-related bone marrow suppression

作　　者：薛静[1] 夏广惠[2] 唐瑶[1] 汪蕾[3] XUE Jing;XIA Guang-hui;TANG Yao;WANG Lei(Department of Respiratory,Nanjing Chest Hospital,Nanjing,Jiangsu 210029,China;不详)

机构地区：[1]南京市胸科医院呼吸科,江苏南京210029 [2]南京市胸科医院护理部,江苏南京210029 [3]南京市胸科医院急诊科,江苏南京210029

出　　处：《中国临床研究》2022年第10期1476-1480,共5页Chinese Journal of Clinical Research

基　　金：江苏省医院管理创新研究课题(JSYGY-3-2020-456)。

摘　　要：目的 探讨在肺癌化疗致骨髓抑制患者经外周静脉置入中心静脉导管(PICC)相关感染预防中抗菌敷料的应用及效果。方法 将2019年10月至2021年10月南京市胸科医院95例肺癌化疗致骨髓抑制携带PICC导管患者分为三组,使用葡萄糖酸氯己定敷料组(A组)31例,使用碘伏纱布敷料组(B组)32例,使用透明敷料组(C组)32例,观察不同敷料使用效果。结果 三组局部感染中渗血和渗液,淋巴管炎和化脓发生率差异无统计学意义(P>0.05);C组发红、触痛、皮肤温度增高、硬结(任何两种以上表现)之局部感染发生率(56.2%)高于A组(3.2%)、B组(9.4%),差异有统计学意义(P<0.01);B组维护次数明显高于其他两组,差异有统计学意义(P<0.05);病原菌检出数量中,A组检出病原菌2株、B组4株、C组9株,C组病原菌检出率稍高于A组、B组,但差异无统计学意义(P>0.05)。结论 抗菌敷料中葡萄糖酸氯己定敷料与碘伏纱布敷料的运用可有效降低肺癌化疗致骨髓抑制患者PICC导管局部感染的发生。能否在减少细菌定植上有统计学意义的获益,有待进一步观察。Objective To explore the effect of antibacterial dressing on prevention of peripherally inserted central catheter(PICC) catheter-related infection in lung cancer patients with bone marrow suppression caused by chemotherapy.Methods A total of 95 lung cancer patients with chemotherapy-induced myelosuppression and PICC catheter were selected and divided into three groups according to different dressing used.There were 31 cases treated with chlorohexidine gluconate dressing(group A),32 cases with iodophor gauze dressing(group B) and 32 cases with transparent dressing(group C).The effects of different dressings on preventing infection were observed in three groups.Results There was no significant difference in the incidence of local infection,including bleeding and exudation,lymphangitis and suppuration among the three groups(P>0.05).The incidence of local infection such as redness,tenderness,increased local temperature and induration(any two or more manifestations) in group C(56.2%) was significant higher than that in group A(3.2%) and group B(9.4%)(P0.05).Conclusion On prevention of PICC catheter-related infection in lung cancer patients with bone marrow suppression caused by chemotherapy,the chlorhexidine gluconate dressing and iodavor gauze dressing can effectively reduce the occurrence of local infection of PICC catheter,and whether there is a statistically significant benefit in reducing bacterial customization remains to be observed.

关 键 词：肺癌 骨髓抑制 经外周静脉置入中心静脉导管 抗菌敷料 感染 

分 类 号：R472[医药卫生—护理学]