肝素预防新生儿经外周中心静脉置管相关感染的回顾性研究.pdfVIP

论  著   原始研究• 中国循证医学杂志2010, 10(9): 1023 ～1026 肝素预防新生儿经外周中心静脉置管相关感染 的回顾性研究 唐  军  熊  英* 四川大学华西第二医院儿科（成都610041 ） 摘要  目的 观察全合一静脉营养液中加入小剂量肝素持续输注对新生儿经外周导入中心静脉置管（PICC ） 相关感染的预防作用。方法 将我院新生儿重症监护病房2007.5 ～2008.12 行PICC 置管的103 例患者分为两组： 肝素组（n=63 ）在全合一营养液中加入肝素0.5 U/mL ，对照组（n=40 ）不加肝素，回顾性分析比较两组导管相关性 败血症（CRI ）发生情况。结果 肝素组发生导管堵塞4 例（6.3% ），导管内细菌定植1 例（1.58%），导管相关血流感 染0 例；对照组发生导管堵塞8 例（20% ），导管内细菌定植7 例（17.5%），导管相关血流感染5 例（12.5%），两组比 较其差异均有统计学意义（P0.05 ）。结论 静脉营养液中加入0.5 U/mL 的肝素可减少PICC 堵管，预防导管相关 感染发生。 关键词 经外周导入中心静脉置管；导管相关感染；肝素；全合一静脉营养液；新生儿；回顾性分析 The Role of Heparin in Prevention of Neonatal Catheter-related Complications in Peripherally Inserted Central Catheters TANG Jun, XIONG Ying* The Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610041, China Abstract Objective To investigate the role of low-dose heparin added to total nutrient admixture (TNA) solu- tions in the prevention of catheter related infections (CRIs). Methods One-hundred three newborn infants with periph- erally inserted central catheter (PICC) were divided into heparin group (n=63) and control group (n=40). The patients in the heparin group received TNA with 0.5 U/ ml heparin. The patients in the control group received TNA without heparin. We retrospectively analyzed the incidence of CRTs in the two groups. Results We found that the incidence of CRIs was 0 in the heparin group and 12.5% (5/40) in the control group. The incidence of catheter obstruction was 6.3% (4/63) in the heparin group and 20% (8/40) in the control group. The incidence of catheter-tip colonization was 1.58% (1/40) in the heparin group and 17.5% (7/40) in the control group. The incidences of CRIs, catheter obstruction, and catheter-tip colonization were significantly lower in the heparin group than those in the control group (P0.05). Conclusion TNA solutions with 0.5U/ml heparin have decreased catheter obstruction and CRIs. Key words Peripheral