血液透析患者股静脉置管导管感染病原菌及治疗效果分析

目的探讨血液透析（HD）患者股静脉置管后导管感染的病原菌及治疗措施。方法选取本院城东病区2011年4～12月58例股静脉置管HD患者,分别在置管后每周行导管血细菌培养和药敏试验,共观察10周。全身感染者留取外周血和导管血标本进行培养,给予经验性抗生素治疗,首选万古霉素、头孢硫脒行导管封管,血培养阳性者根据药敏结果选用抗生素,疗程为1周。结果 58例股静脉置管患者中,8例发生导管感染,感染率为13.79%;距置管感染时间为（50.25±13.76）天,主要病原菌为革兰阳性菌。导管培养阳性者使用万古霉素或者头孢硫脒封管治疗1周后,导管培养复查均转为阴性。结论导管血培养有助于早期发现HD患者股静脉导管感染,抗生素封管是治疗导管感染的有效措施。

Infection caused by femoral vein catheters in hemodialysis:Analysis of pathogenic bacteria and therapeutic efficacy

Objective To explore the pathogenic bacteria and therapy of catheter-related infection in hemodialysis patients undergoing femoral vein cannulation. Methods Fifty-eight cases of hemodialysis patients with indwelling femoral vein catheters in our dialysis center from April to Dec 2011 underwent blood bacterial culture and drug susceptibility test every week for ten weeks. Results Infection occurred in 8 cases(13.79%).The time between cannulation and infection was(50.25±13.76) days.Gram-negative bacteria were the main pathogenic organisms.The infected patients got negative experimental results after treated by Vancomycin and Cefathiamidine. Conclusions Blood culture of catheter bacteria is helpful for discovering early femoral vein catheter-related infection.The antibiotic therapy is an effective measure for catheter-related infection.