无菌保护帽对血液透析患者导管相关性感染的影响  

Effect of Sterile Protective Caps on Catheter-Related Infections of Hemodialysis Patients

作　　者：景海宁 杨莉 JING Haining;YANG Li(Department of Nephrology,Shaanxi Provincial Nuclear Industry No.215 Hospital,Xianyang,Shaanxi 712000)

机构地区：[1]陕西省核工业二一五医院肾内科,陕西咸阳712000

出　　处：《智慧健康》2024年第6期64-67,71,共5页Smart Healthcare

摘　　要：目的 探讨无菌保护帽对血液透析患者导管相关性感染的影响及应用价值。方法 选择2021年9月—2022年11月本院肾内科确诊的慢性肾功能衰竭,需要进行血液透析并使用无隧道无涤纶(NCC)导管-股静脉临时导管作为血管通路的患者共60例作为研究对象,按照随机分组法分为对照组(n=30)和实验组(n=30),对照组NCC导管透析间期使用普通肝素帽,实验组股静脉NCC导管透析间期使用无菌保护帽,观察两组患者的血常规、红细胞沉降率(ESR)、C反应蛋白(CRP)、白蛋白(ALB)、铁蛋白(TF)、降钙素原(PCT)、白介素-6(IL-6),在实验2周、4周后对导管口局部进行物表培养,在实验4周后对导管内动静脉端血进行细菌培养,观察是否出现细菌生长。结果 观察2周、4周时,实验组患者的白细胞计数、中性粒细胞、ESR、ALB、TF虽低于对照组,但差异无统计学意义(P>0.05);实验组患者的CRP、PCT、IL-6低于对照组,差异有统计学意义(P<0.05);在导管物表的培养中,对照组患者7例出现了细菌生长(2周出现2例、4周出现5例),实验组有2例(2周出现1例、4周出现1例)。在导管血培养中,对照组患者4例出现了细菌生长,实验组有0例,差异具有统计学意义(P<0.05)。结论 无菌保护帽在血液透析患者的NCC导管相关性感染中具有一定的应用价值,能减轻患者体内的炎症反应,抑制局部细菌生长,值得临床推广。Objective To explore effect and application value of sterile protective caps on catheter-related infections of hemodialysis patients.Methods The paper chose 60 patients diagnosed with chronic renal failure in Nephrology Department of our hospital from September 2021 to November 2022 as study subjects,treated with hemodialysis and non tunnel non polyester(NCC)catheter femoral vein temporary catheter as vascular access,and divided them into control group(n=30)and experimental group(n=30)randomly.Control group was treated with regular heparin caps during NCC catheter dialysis interval,experimental group with sterile protective caps during dialysis interval of femoral vein NCC catheter.Blood routine,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),albumin(ALB),ferritin(TF),procalcitonin(PCT),and interleukin-6(IL-6)was observed between two groups.After 2 and 4 weeks of experiment,surface culture was performed on catheter opening.After 4 weeks of experiment,bacterial culture was performed on arterial and venous end blood of the catheter to observe whether bacterial growth occurred.Results At 2 and 4 weeks of observation,white blood cell count,neutrophils,ESR,ALB,and TF of experimental group were lower than control group,difference was not statistically significant(P>0.05).CRP,PCT,and IL-6 of experimental group was lower than control group,difference was statistically significant(P<0.05).During culture of catheter surface,7 cases in control group showed bacterial growth(2 cases at 2 weeks and 5 cases at 4 weeks),while there were 2 cases in experimental group(1 case at 2 weeks and 1 case at 4 weeks).During catheter blood culture,4 cases in control group showed bacterial growth,there was 0 case in experimental group, with statistical difference (P<0.05). Conclusion Sterile protective caps have some certain application value in treatment of non tunnel non polyester (NCC) catheter-related infections of hemodialysis patients, can reduce inflammation in body of patients, inhibite local bacterial growth, which is wo

关 键 词：无菌保护帽 血液透析 相关性感染 

分 类 号：R473.5[医药卫生—护理学]