摘要
目的研究血液透析患者股静脉插管留置时间对细菌定植的影响，探讨其留置的最佳时间。方法将符合标准的60例患者按留置时间分为3组（A组〈1周、B组1～2周、C组〉2周），拔管时对每例患者皮肤采样，对拔出的导管尖做细菌培养，比较菌落数和菌种分布，并记录拔管时局部皮肤的感染情况。结果留置时间越长，穿刺部位细菌定植数、局部皮肤的感染发生率及导管尖细菌培养阳性率越高；C组与B组比较，插管处皮肤细菌定植率为100％与25％（P〈0．01）及拔管前局部皮肤细菌定植数明显升高，（95．15±10．18）与（9．40±1．88）CFU／cm^2，（P〈0．01），而B组与A组差异无统计学意义；3组间拔管时局部皮肤感染发生率和导管尖细菌培养的比较也有相同变化。结论通过细菌定植的检查结，可以确定血液透析患者股静脉插管留置的最佳时间为1～2周。
OBJECTIVE To study the effects of indwelling time of femoral vein catheter on bacterium colonization in patients with hemodialysis treatment, then to choose the optimal one from infection prevention viewpoint. METHODS The patients were divided randomly into three groups according to their catheter indwelling time （group A〈1 week, group B 1--2 weeks, group C 〉2 weeks） （20 patients in each group）. Samples from skin and the tip of the catheter were cultured, and compared the colony number and strain distribution. RESULTS There was bacterium colonization on punctured skin and the tip of the catheter after using it for a long time. The longer it was,the higher the positive rate was. The positive rate of bacterium colonization in groups B, and C was 25% vs 100% （P〈0. 01） and their colony number （9. 40±1.89） vs （95. 15±10. 18） CFU/cm^2, （P〈0.01）. The cutaneous bacterium colonization before catheter removal was significantly increased in group C, and there was no significant difference between groups A and B. The positive rate of cutaneous infection and the tip of the catheter had the same trend among three groups. CONCLUSIONS The optimal time duration of using femoral vein catheter is 1- 2 weeks based on the results of bacterium colonization.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2009年第12期1521-1523,共3页
Chinese Journal of Nosocomiology
关键词
血液透析
股静脉插管
留置时间
细菌定植
Hemodialysis
Femoral vein catheter
Time duration
Bacterium colonization
