肿瘤化疗患者浅静脉留置针细菌培养结果分析

目的分析肿瘤患者浅静脉留置针周围皮肤及针尖细菌感染的特点,以更好地指导护理工作.方法对143例需静脉化疗的肿瘤患者进行浅静脉留置针穿刺后,采集留置针周围皮肤及针尖部标本进行细菌培养阳性结果分析.结果细菌检出以革兰氏阳性菌为主;143例286例次中,皮肤检出38例次,检出率26.6%;针尖检出20例次,检出率14.0%;留置时间≤4 d组的细菌总检出率为11.1%,5～7 d组的细菌总检出率为46.9%,两者比较,差异有显著性意义(P<0.01);>7 d组的细菌检出率为88.2%,与前两组比较,差异有显著性意义(P<0.01,P<0.05).结论肿瘤化疗浅静脉留置针留置时间越长,被细菌污染的可能性越大;应加强置管护理,加强局部皮肤的清洁消毒工作;留置时间最好控制在4 d左右.     

肿瘤化疗患者浅静脉留置针细菌培养结果分析

目的分析肿瘤患者浅静脉留置针周围皮肤及针尖细菌感染的特点，以更好地指导护理工作。方法对143例需静脉化疗的肿瘤患者进行浅静脉留置针穿刺后，采集留置针周围皮肤及针尖部标本进行细菌培养阳性结果分析。结果细菌检出以革兰氏阳性菌为主；143例286例次中．皮肤检出38例次，检出率26．6％；针尖检出20例次。检出率14．0％；留置时间≤4d组的细菌总检出率为11．1％，5～7d组的细菌总检出率为46．9％，两者比较。差异有显著性意义（P〈0．01）；〉7d组的细菌检出率为88＋2％．与前两组比较。差异有显著性意义（P〈0．04，P〈0．05）。结论肿瘤化疗浅静脉留置针留置时间越长。被细菌污染的可能性越大；应加强置管护理，加强局部皮肤的清洁消毒工作；留置时间最好控制在4d左右。     

血液病患者浅静脉留置针细菌污染及临床特点分析

目的探讨血液病患者浅静脉留置针菌群污染特点,为针对性地预防提供依据。方法对135例采用浅静脉留置针化疗的血液病患者拔针后其针尖行细菌培养。结果135例中,21例(15.56%)细菌污染,且以革兰氏阳性菌为主;留置时间越长、白细胞计数越低,其感染率越高,差异有显著性意义(P<0.05)。结论对血液病浅静脉留置针化疗患者应加强置管护理,留置针置管时间以患者白细胞计数而定。     

PICC置管在乳腺癌化疗中的临床应用

目的探讨经外周置入中心静脉导管与浅静脉留置针在乳腺癌化疗中的临床效果。方法把139名乳腺癌化疗的随机分为2组,观察组50例给予PICC;对照组89例给予浅静脉留置针,比较2组并发症发生率及留置时间的长短。结果 PICC组并发症如静脉炎明显少于浅静脉留置针组,差异有统计学意义(P<0.05)。留置时间明显长于浅静脉留置针组,差异有统计学意义(P<0.01)。结论 PICC并发症比较少,留置时间长,操作简单安全,无不良作用,无痛苦,值得临床推广应用。     

三种下肢静脉穿刺置管方法效果比较

目的 寻找下肢静脉最佳的穿刺置管方法.方法 将经下肢化疗的85例肿瘤患者分为三组.外周深静脉组23例,选择内踝大隐静脉起始处或小腿内侧,以15°～30°角进针行静脉穿刺,置入16 G PICC导管至大隐静脉末段或股静脉,经X线拍片证实导管尖端位置正确后接通输液装置输液;股静脉组41例,选择股动脉搏动最明显部位的内侧0.5 cm处,针头指向患者头部、与皮肤呈30°～45°角穿刺,王入16 G单腔中心静脉导管输液;外周留置针组21例,采用18～22 G贝朗留置针,选择下肢浅静脉行静脉穿刺王管输液.结果 三组一次置管成功率及操作平均耗时、化疗性静脉炎发生率总体比较差异有统计学意义(P<0.05,P<0.01),股静脉组成功率最低且耗时最多,外周留置针组化疗性静脉炎发生率最高;外周深静脉组导管平均留置时间显著短于股静脉组(P<0.05),两组并发症发生率比较差异无统计学意义(P>0.05),但股静脉组发生严重感染1例.结论 为预防化疗性静脉炎,应避免使用外周静脉而选择深静脉给药.外周深静脉置管与股静脉穿刺王管比较,操作简单、一次操作成功率高、耗时少,无严重并发症,是下肢深静脉置管较理想的方式.     

PICC与锁骨下静脉置管在肿瘤患者化疗中的应用效果比较

目的 探讨PICC与锁骨下静脉置管在肿瘤化疗患者中的应用效果,为临床护理工作提供依据.方法 将80例肿瘤化疗患者根据所选择导管类型分成PICC组和锁骨下静脉置管组各40例,比较两组置管成功率、导管留置时间、并发症发生率.结果 两组一次穿刺置管成功率、导管留置时间比较,PICC组显著优于锁骨下静脉置管组(均P＜0.01);两组并发症发生率比较,差异无显著性意义(P＞0.05),但锁骨下静脉置管组发生严重感染2例、血气胸1例、动脉损伤2例,PICC组无严重并发症发生.结论 PICC一次穿刺置管成功率高、留置时间长,无严重并发症发生,可作为肿瘤患者长期化疗的首选.     

Y型与L型留置针在手术中的应用效果评价

目的 探讨Y型和L型浅静脉留置针的应用效果,为手术室护士选择合适留置针提供依据.方法 将200例择期手术患者随机分成Y组和L组.分别采用Y型和L型留置针.结果 Y组一次穿刺成功率显著高于L组,操作时间显著短于L组(P<0.05, P<0.01);L组输液速度显著快于Y组,血液回流污染率显著高于Y组(均P<0.01).结论 应根据Y型和L型留置针的性能特点在手术中选择合适的留置针.     

负压技术在静脉留置针穿刺困难患者中的应用

目的提高静脉留置针穿刺困难者的一次穿刺成功率。方法将200例需行静脉留置针穿刺的患者随机分为对照组和观察组,各100例。对照组按常规穿刺,观察组采用负压技术穿刺,即将容量为2ml的吸球和三通接头接上留置针,使之穿刺时形成负压,再行穿刺。结果两组静脉穿刺回血率、一次成功率比较,差异有显著性意义(χ2=18.32、27.56,均P<0.01);留置针保留时间比较,差异无显著性意义(P>0.05);两组颈外静脉、大隐静脉穿刺回血率、一次穿刺成功率比较,差异有显著性意义(χ2=18.26、18.26、5.00、5.00,P<0.01或P<0.05);两组股静脉一次穿刺成功率比较,差异有显著性意义(P<0.01)。结论负压技术可提高留置针穿刺回血率和一次穿刺成功率。     

头皮静脉留置针不同穿刺部位留置时间比较

目的探讨小儿头皮留置针不同穿刺部位的留置时间。方法将200例小儿肺炎患儿随机分成四组各50例,分别采取额前中静脉、眶上静脉、颞浅静脉和耳后静脉进行留置针穿刺输液,按照常规输液护理,比较其留置时间。结果额前中静脉组、颞浅静脉组留置时间显著长于眶上静脉组和耳后静脉组。结论额前中静脉和颞浅静脉比较适合小儿头皮留置针穿刺。     

静脉留置针封管频次与静脉炎关系的实验研究

目的探讨静脉留置针封管频次与静脉炎的关系.方法取种系相同、体重相近的新西兰健康大耳白兔21只,以兔双耳外侧的耳缘静脉作为实验血管,随机分成第1组(n=22)和第2组(n=20),采用静脉留置针输液,以10 gtt/min的速度输入0.9%氯化钠注射液30 ml,1次/d.第1组液体输注完毕用肝素盐水封管1次,与下次输液间隔时间为23 h 15 min;第2组在第1次封管后12 h再封管1次,第2次封管与次日输液间隔时间为11 h 15 min.两组均保留72 h,第1组封管3次、第2组封管6次后拔除静脉留置针.以穿刺点为起点取长2 cm、宽1 cm含静脉血管和耳廓组织的活体标本做病理切片,观察静脉血管的病理变化.结果两组血管壁未发现炎性细胞浸润,炎性细胞均分布在血管周围组织;两组血管周围组织炎症发生情况比较,差异有显著性意义(均P<0.01);两组血管内血栓形成情况基本相同(均P>0.05).结论相同留置时间,增加静脉留置针封管次数可加重静脉周围组织炎症的程度.     

Microbiological risk of anaesthetic breathing circuits after extended use

Introduction: Daily change of breathing circuits in the operating theatre requires a lot of resources and is time and labour consuming. The extended use of breathing circuits could reduce the workload of the staff and health care costs. The aim of the present study was to evaluate the contamination rate of anaesthesia breathing circuits changed after 24, 48 or 72 h of use.
Materials: The study was performed as an experimental observational study. Microbiological samples were taken from 112 breathing systems including both parts of the ventilator circuit (inspiration and expiration) and analysed using microbiological standard techniques. Breathing circuits were changed according to three different schedules. In the 24-h group, breathing circuits were changed every day, whereas in the 48-h group changing of the circuits took place on Mondays, Wednesdays and Fridays. A period of 72 h operating use was tested on weekends.
Results: A total of 112 breathing systems comprised of 224 samples from the ventilator circuit were tested for bacteria and yeast contamination. A non-significant increase in the contamination rate was observed with the extended use for breathing circuits (24 h: 3.33%, 48 h: 4.35% and 72 h: 5.56%; P for trend=0.66). Similarly, no significant increase in contamination rate could be observed at the sample level (24 h: 1.67%, 48 h: 3.26% and 72 h: 2.78%; P for trend=0.71).
Conclusion: The extended use of breathing circuits for 48 and 72 h does not increase significantly the risk of contamination, provided that HME filters are changed separately for every patient.     

外科感染常见致病菌耐药性监测报告

１９９６年１月至１９９７年１月收集武汉地区外科感染病原菌１１１１株，其中革兰阳性球菌４２６株，革兰阴性杆菌６８５朱，用Ｋｉｒｂｙ－Ｂａｕｅｒ方法检测１７种抗菌药的敏感性。     

Prostate specific antigen and prostatitis. II. PSA production and release kinetics in vitro.

Elevations in serum prostate specific antigen (PSA) levels in patients with prostatitis are well known, but the pathophysiologic mechanisms involved with this phenomenon are poorly understood. We have recently evaluated the effect of prostatitis on PSA levels in primates. This data demonstrated a rapid rise in PSA, which subsequently fell along the biological decay curve. This suggested a release of sequestered PSA. We evaluated the effect of infection upon PSA production for the prostatic adenocarcinoma cell line LNCaP. The cell line was determined to produce 9.6 +/- 2.7 fg/cell/hr PSA with essentially linear kinetics. No effect was seen with dead bacteria, bacterial supernatant or complement upon the PSA production. Live E. coli had no effect for 4-8 hours at which time the cells sloughed and PSA production ceased. No release of stored PSA was seen. These data do not elucidate the reasons for increased serum PSA levels found with acute bacterial prostatitis, but indicate that it is not a storage phenomenon.     

锌硒宝辅助治疗慢性细菌性前列腺炎

目的 :探讨锌硒宝口服片辅助治疗慢性细菌性前列腺炎的效果。　方法 :对 38例慢性细菌性前列腺炎患者联合应用锌硒宝片剂和敏感抗生素 (A组 ) ,4 3例慢性细菌性前列腺炎患者单用敏感抗生素 (B组 ) ,对两组的疗效进行对比研究。　结果 :A组的疗效明显高于B组。　结论 :锌硒宝片剂是一种能有效治疗慢性细菌性前列腺炎、改善其症状的药物。     

Secretion of various antimicrobial substances in dogs with experimental bacterial prostatitis

Summary Bacterial prostatitis in dogs was induced by injection of an E. coli 06 suspension into a branch of the prostatic artery.Three to six days later, secretion from the inflamed glands was obtained by pilocarpine stimulation and the concentrations of trimethoprim, sulphamethoxazole, erythromycin, doxycycline and ampicillin were measured during constant infusion of these drugs. In the prostatic secretion, only the concentrations of the lipid soluble substances trimethoprim and erythromycin exceeded the corresponding plasma levels. These two substances may therefore be of value in the treatment of bacterial prostatitis.     

Secondary amyloidosis from long-standing bacterial endocarditis

Survival of patients with increasingly complex congenital heart disease has produced a population of children and adolescents who are susceptible to subactue bacterial endocarditis (SBE). We report a child whose endocarditis went unrecognised, and who developed amyloidosis. Asymptomatic proteinuria, haematuria and renal impairment are occasionally seen in SBE and usually indicate glomerulonephritis. Amyloidosis should also be suspected in children with long-standing bacterial endocarditis with proteinuria or other evidence of renal impairment, especially if associated with organomegaly. The diagnosis is made by renal biopsy.