长效物理抗菌材料应用于中心静脉导管相关性感染的有效性及安全性分析.docVIP

长效物理抗菌材料应用于中心静脉导管 相关性感染的有效性及安全性分析 马佩芬 王东敏 张秀 张玉芳 柴晔 兰州大学第二医院血液科 西北民族大学医学院 兰 州大学第二医院骨科兰州大学第二医院护理部 摘要： 目的探讨长效物理抗菌材料“洁悠神”应用于中心静脉导管相关性感染的有效 性及安全性，为中心静脉导管相关性感染预防提供依据。方法选择2015年1 月-2017年2月于医院接受脊柱外科手术治疗且术后留置中心静脉导管的120例 患者为研究对象，分为对照组与试验组各60例，所有患者术前血培养均为阴性, 对照组采用洗必泰预防术后中心静脉导管相关性感染，试验组采用洁悠神局部 喷洒预防感染，两组均留取血标本，进行血培养，置管7、14d分别拔除10例导 管进行插入点导管细菌培养，统计两组患者置管期间感染的发牛率，利用激光 扫描共聚焦显微镜观察两组中心静脉导管的插入点导管表面细菌生物膜形成情 况，记录不良反应，并采用视觉模拟评分表(VAS)评估两组患者疼痛程度。结 果 试验组患者血培养感染率为3. 33%,低于对照组的18. 33% (P0. 05);两组病 原菌分布均以表皮葡萄球菌、金黄色葡萄球菌为主;试验组患者导管维护后24h 贴膜卷边率及渗液率均低于对照组(P0.05);试验组患者不同留置时间穿刺部 位疼痛评分均低于对照组(P0. 05)。结论 在中心静脉导管相关性感染预防中 采用长效抗菌材料洁悠神可降低CVC相关性感染的风险，且安全性较好。 关键词： 中心静脉导管;感染;洁悠神;洗必泰; 作者简介：柴晔，E-mail:pap订lon2009@163. com 收稿日期：2017-08-11 基金：甘肃省青年科技基金资助项Fl (1606RJYA230);甘肃省青年科技基金资助 项目(17JR5RA280) Effectiveness and safety of application of long-acting antimicrobial material in central venous catheter related infection MA Pei-fen WANG Dong-min ZHANG Xiu ZHANG Yu-fang CHAI Ye The Second Hospital of Lanzhou University; Abstract： OBJECTIVE To investigate the effectiveness and safety of application of JUC long-acting antimicrobial material in central venous catheter (CVC) related infections, so as to provide the basis for prevention of CVC related infections. METHODS A total of 120 patients who underwent spinal surgery and indwelling CVC in our hospital from Jan. 2015 to Feb. 2017 were enrolled in the study, and were divided into control group and experimental group, with 60 cases in each group. The blood culture results of al 1 patients were negative. Patients in control group were treated with chlorhexidine for prevention of CVC related infections after surgery, while in experimental group were treated with JUC local spraying for prevention of infection. Blood samples of the two groups were collected for blood culture, and catheter bacterial culture of 10 removed cases at insertion point was performed on the7 th and 14 th day after catheterizing. The incidenee of infection during catheterization was statistically anal