深静脉置管血液透析患者真菌感染的易感因素及护理对策

目的探讨血液透析患者带涤纶环深静脉留置导管真菌感染的易感因素，为临床制订预防感染的护理措施提供理论依据。方法观察24例采用带涤纶环深静脉留置导管行维持性血液透析患者真菌感染发生率、临床表现、治疗转归，并分析易感因素。结果5例（20.83％）发生导管相关性真菌感染，感染真菌均为假丝酵母菌，药物敏感试验提示氟康唑敏感性最高；氟康唑导管内滴注治疗3例有效；导管相关性真菌感染与近期抗生素的应用、导管置入时间有关（均P〈0.05）。结论导管相关性真菌感染不可忽视，了解其临床特点、易感因素，采取针以性预防措施，对减少感染发生率、延长导管的使用寿命具有重要意义。

Susceptible Factors of Fungal Infections in Hemodialysis Patients with Silicone Dual-lumen Catheter with a Dacron Cuff and Nursing Care

Objective To explore incidence, effectiveness of treatment and susceptible factors of fungal infections related to silicone dual-lumen catheter with a dacron cuff in hemodialysis patients.Methods In 24 hemodialysis patients who were indwelled deep venous catheter, incidence, clinical manifestation, effectiveness of treatment and susceptible factors were observed and analyzed. Results The incidence of catheter-related fungi infections was 20.83%. All of the infective fungi related to catheter were Candida mycoderma, which were the most susceptible to fluconazole according to the drug sensitivity test,and the effectiveness of fluconazole used from the catheter was btained in 3 cases. Catheter-related fungi infections were related to the recent usage of antibiotics and period of indwelling catheters (P<0.05 for all).Conclusion The catheter related fungi infection cannot be ignored. It is important to master the clinical feature,the susceptible factors and preventive methods for decreasing the infective incidence and prolonging the useage time of the catheter.