中心静脉导管敷贴更换频率对敷贴下皮肤细菌定植的影响  

Effect of the replacement frequency of central venous catheter dressing on skin bacterial colonization under the dressing

作　　者：王文超 沈伟杰 顾莺 徐昱璐 张青青 王传清[5] 何磊燕 窦亚兰 Wang Wen-chao;Shen Weijie;Gu Ying;Xu Yulu;Zhang Qingqing;Wang Chuanqing;He Leiyan;Dou Yalan(Emergency Department,Children's Hospital of Fudan University,Shanghai 201102,China)

机构地区：[1]复旦大学附属儿科医院急诊科,上海201102 [2]复旦大学附属儿科医院重症监护室,上海201102 [3]复旦大学附属儿科医院护理部,上海201102 [4]复旦大学附属儿科医院心脏监护室,上海201102 [5]复旦大学附属儿科医院院内感染控制与防保办公室,上海201102 [6]复旦大学附属儿科医院细菌室,上海201102 [7]复旦大学附属儿科医院临床研究中心,上海201102

出　　处：《护理学杂志》2023年第5期9-12,共4页Journal of Nursing Science

基　　金：上海市地方高水平大学建设项目——循证护理全链条创新研究项目(FNDGJ202008)。

摘　　要：目的探讨中心静脉导管敷贴更换频率是否对敷贴下皮肤细菌定植率产生影响。方法对PICU和CICU留置中心静脉导管的试验组(29例)在首次留置中心静脉导管24 h后不更换敷贴,在留置导管的第7天更换敷贴;对照组(28例)在首次留置中心静脉导管24 h后更换敷贴,在留置导管的第8天再次更换敷贴。试验组在第7天、对照组在第8天更换敷贴时对敷贴下皮肤进行采样,比较两组皮肤细菌定植的差异性。结果两组皮肤细菌定植率比较,差异无统计学意义(P>0.05)。两组共培养了228个采样点,其中61个采样点(26.75%)出现阳性结果;两组间各采样部位细菌培养阳性率比较无统计学差异(均P>0.05)。两组均未发生中心静脉导管相关性血流感染及医用粘胶相关性皮肤损伤。结论在严格无菌屏障下留置中心静脉导管,置管24 h后不更换敷贴不会增加敷贴下皮肤细菌定植。Objective To explore whether the replacement frequency of central venous catheter dressing has an effect on the incidence of skin bacterial colonization under the dressing.Methods A total of 29 children indwelling central venous catheter from PICU and CICU were taken as an experimental group,the dressing wasn't replaced after 24 hours of the first indwelling of the central venous catheter,until the 7th day of the indwelling catheter;and other 28 children of their counterparts were regarded as a control group,whose dressing was replaced after 24 hours of the first indwelling of catheter,and was changed again on the 8th day of the indwe-lling catheter.When the dressing was replaced,the skin under the dressing was sampled at the 7th day for the experimental group,and at the 8th day for the control group,to compare skin bacterial colonization of the two groups.Results There wasn't significant difference in the incidence of skin bacterial colonization between the two groups(P>0.05).Totally 228 sample sites were cultiva-ted in the two groups,and skin bacterial colonized in 61(26.75%)of the sites;and there weren't significant differences in positive rate in each sample site between the two groups(all P>0.05).Central venous catheter-related bloodstream infection and medical adhesive skin injury weren't observed in the two groups.Conclusion When indwelling central venous catheter under strict sterile barrier,not replacing the dressing after 24 hours of central venous catheter placement will not increase the incidence of skin bacte-rial colonization under the dressing.

关 键 词：儿童 中心静脉导管 敷贴 更换频率 皮肤细菌定植 中心静脉导管相关性血流感染 医用粘胶相关性皮肤损伤 静脉治疗 

分 类 号：R472[医药卫生—护理学]