头孢他啶-肝素封管预防血液透析患者深静脉置管感染

背景:导管相关性感染已成为临床棘手的严重并发症之一,也是导致血液透析患者导管停止使用和死亡的重要因素。目的:评价抗生素-肝素封管方法预防血液透析患者深静脉置管感染的临床效果。方法:348例慢性肾功能衰竭患者,随机分为实验组和对照组,实施深静脉置管后,实验组给予头孢他啶-肝素混合液封管,对照组行肝素封管。记录并比较留置导管期间两组的导管相关性感染、导管栓塞、局部出血、意外脱落的发生率。结果与结论:实验组导管相关性感染的发生率、血行感染和导管定植发生率均显著低于对照组,差异有显著性意义(P=0.001,P=0.017,P=0.026),而两组在出口感染发生率、导管栓塞、局部出血、意外脱落的发生率上差异均无显著性意义(P=0.300,P=0.431,P=0.535,P=0.634)。说明头孢他啶-肝素混合液进行封管可以有效降低深静脉置管感染的发生率,是一种有效、安全、简单的方法。

Ceftazidime-heparin lock therapy prevents deep vein catheter related infections in hemodialysis patients

BACKGROUND:Deep vein catheter related infection is one of the serious complications of hemodialysis,which leads to the cessation of hemodialysis and even death of patients.OBJECTIVE:To evaluate clinical effect of antibiotic-heparin lock therapy on prevention of deep vein catheter related infections in hemodialysis patients.METHODS:348 patients with chronic renal failure were randomly divided into experimental group and control group.After administration of deep vein catheter,ceftazidime-heparin lock therapy and heparin lock therapy were performed in experimental group and control group respectively.The incidences of catheter related infection,catheter blocking,local bleeding and unexpected catheter loss in two groups were recorded and compared.RESULTS AND CONCLUSION:In the experimental group,incidence of catheter related infection was significantly lower than that in the control group (P=0.001).The incidences of blood stream infection and catheter colonization in experimental group were significantly lower than those in control group (P=0.017,P=0.026),but there was no significant difference in the incidence of local catheter related infection,blood stream infection and catheter colonization between the two groups (P=0.300,P=0.431,P=0.535,P= 0.634).Antibiotic-heparin lock therapy can significantly decrease the incidence of deep vein catheter related infections,which is an effective,safe and easy method with great potential in clinical application.