课件--静脉_输液.ppt

美国疾病控制中心（CDC)发布的《预防血管内导管相关性血流感染》（2006版）中指出，通过三项不同的对照性研究结果【15-17】表明，输液装置的更换频率超过72h是安全及节省成本的，近期另一项研究结果表明每96h更换输液装置与每72h更换输液装置相比较，静脉炎的发生率没有实质的不同【18】。 敷料、输液器、输血器和输液接头的应用与更换 【证据】 [15]Josephson A, Gombert MF, et al. there relationship between intravenous fluid contamination and the frequency of tubing replacement. Infect Control, 1985,6:367-370. [16]Maki DG, Botticelli JT, Leroy ML, et, al. Prospective study of replancing administration sets for intravenous therapy at 48-vs 72-hour intervals: 72 hours is safe and cost-effective, JAMA, 1987, 258:1777-1781. [17] Snydman DR, Donnelly-Reidy M, Perry LK,et al. Intravenous tubing containing burettes can be safely changed at 72 hour intervals. Infect Control, 1987,8:113-116. [18] Lai KK. Safety of prolonging peripheral cannula and i. v. tubing use from 72 hours to96 hours. Am J Infect control, 1998, 26:66-70. 当输入一些有利于微生物生长的液体（比如脂肪乳、血液和血液制品）时，需增加输液装置的更换频率，即要缩短更换的间隔时间，此类液体被认为是引起导管相关性血液感染的危险因素【19-25】 。 敷料、输液器、输血器和输液接头的应用与更换 【证据】 [19] Hanna HA, Raad II. Blood products:a significant risk factor for longterm catheter-related bloodstream infections in cancer patients. Infect Control hosp Epiemiol,2001,22:165-166. [20] Raad II ,Hanna HA, Awad A, et al. Optimal frequency of changing intravenous sdministration sets: is itsafe to prolong use beyond 72 hours? Onfect control hosp epidemiol, 2001,22:136-139. [21]Saiman L, Ludington E , Dawson JD, et al. Risk factors for candida species colonization of neonatal intensive care unit patients. Pediatr infect Dis J, 2001,20:1119-1124. [22] Avila-figueroa C, Goldmann DA, Richardson DK, et al. Intravenous lipid emulsions are the major determinant of coagulase-negative staphylococcal bacteremia in very low birth weight newborns. Pediatr infect Dis J 1992,17:10-17. [23]Crocker KS, naga R, fillibeck DJ, et al. microbial growth commercial parenteral lipid emulsions. J Parenter enteral nutr, 1984,8:319-395. [24]Jarvis WR, Highsmith AK. Bacteial growth and endotoxin production in lipid emulsion.