中心静脉导管改良消毒方式及置管部位对血液透析患者导管相关性感染发生率的影响

[目的]探讨血液透析中心中心静脉导管(CVC)改良消毒方式及置管部位对血液透析患者导管相关性感染发生率的影响.[方法]选取2016年1月至2017年1月于本院接受CVC置管,并行血液透析治疗的患者200例为研究对象,按照PICC置管时消毒方式不同将其随机分为传统消毒组(A组)和改良消毒组(B组),各100例,比较两组患者导管留置时间、导管相关性感染(CRI)发生率以及不同置管部位导管局部感染率情况.[结果]B组导管留置时间(32.96±14.51)d 明显长于A组(25.38±10.19)d ,B组导管局部感染率6.00％明显低于A组17.00％(P<0.05);两组CRI发生率分别为5.00％、2.00％,比较差异无统计学意义(P>0.05);B组颈内静脉感染率、股静脉感染率明显低于A组(P<0.05).[结论]改良CVC消毒方式有助于延长血液透析患者导管留置时间,降低导管局部感染率,建议临床推广应用.

Effect of Central Venous Catheter Disinfection Methods and Catheterization on the Incidence of Catheter-related Infections of Hemodialysis Patients

[Objective]To investigate the application value of an improved disinfection method of central venous catheter on the prevention and reduction of catheter-related infections of hemodialysis patients.[Methods] A total of 200 cases of patients received central venous catheter and hemodialysis in our hospital from January 2016 to January 2017;they were selected as the research objects and were divided into the conventional disinfection method (Group A) and improved disinfection method (Group B) using the single blind method and random number table method, with 100 cases in each group.The catheter retention, the incidence of catheter-related infection (CRI), and the catheter local infection rate at different catheterization sites were compared between the two groups.[Results] The retention time of catheter in Group B was (32.96 ± 14.51) d and was significantly longer than that in Group A (25.38 ± 10.19) d.The catheter local infection rate in Group B was 6.00 ％ significantly lower than that of 17.00 ％ in Group A (P<0.05).The incidence of CRI in Group A and Group B was 5.00％ and 2.00％, respectively, and the difference was not statistically significant (P>0.05).The infection rate of internal jugular vein and the rate of femoral vein in Group B were significantly lower than those in Group A (P<0.05).[Conclusion] the improved disinfection method is conducive to prolonging the retention time of catheters and reducing the catheter local infection rate in hemodialysis patients, so it is suggested to be popularized and applied in clinical practice.