摘要
目的采用不同种类的抗菌药物与肝素混合液封管预防中心静脉置管感染及其效价比的对照研究。方法对留置中心静脉双腔导管的88例患者,随机分为A组(单纯肝素),B组(头孢他啶+肝素),C组(磷霉素钠+肝素),D组(克林霉素磷酸酯+肝素),观察上述抗菌药物加肝素混合液对置管感染的影响和并发症的发生,以及在同等预防效果时进行价格差异的比较。结果A、B、C、D组中心静脉导管感染发生率分别为33.3%、5.6%、7.4%、4.5%,后3组均较A组明显降低,说明抗菌药物加肝素封管能明显降低静脉导管内感染的发生率;B、C、D3组中心静脉导管感染的发生率差异无统计学意义,但各抗菌药物的价格差异有统计学意义,观察组中克林霉素磷酸酯价格最低;抗菌药物与肝素混合液封管其血栓形成、局部渗血等并发症的发生率与肝素组差异无统计学意义,表明肝素封管液中加用适合的抗菌药物,不增加其并发症的发生率。结论头孢他啶、磷霉素钠、克林霉素磷酸酯分别与肝素混合液封管均有降低中心静脉置管感染的作用,其中磷霉素钠具有预防感染效果肯定,不用稀释、溶解和做过敏试验、操作简便等优点,并能有效降低预防感染的费用。
OBJECTIVE To conduct a comparative study of using the mixture of ceftazidime, fosfomycin sodium, clindamycin phosphate, and other different types of antibiotics with heparin to prevent the central venous catheter infection and their ratio of the effect and cost. METHODS The 88 patients with indwelling dual-chamber central venous catheter hospital were divided into groups A （heparin alone）, B （ceftazidime ＋ heparin）, C （fosfomycin sodium＋heparin） and D（clindamycin phosphate q-heparin） in random. The effects on catheter infection and complications of the above-mentioned mixture of antibiotics plus heparin and their price difference in the same preventive effect were calculated and compared. RESULTS Central venous catheter infection rates in groups four were 33.3%, 5.6%, 7.4% and 4.5%, respectively, the latter three groups were significantly lower than group A, that means, antibiotics plus heparin could significantly reduce the incidence of in{eetion. Among groups B, C and D there was no significant difference, but the price of all antibiotics had significant differences, the price of the clindamycin phosphate was the lowest. Among four groups the incidence of local complications such as hrombosis and hemodiapedesis was no significant difference, that means the closure by heparin in addition to the appropriate antibiotics didn＇t increase the incidence rate of complications. CONCLUSIONS The use of mixture of heparin with ceftazidime, fosfomycin sodium and clindamycin phosphate its to prevent closure of the central venous catheter can, from them the fosfomycin sodium has a definite effect in prevention of infection with out dilution, dissolution and allergy test and with the simple operation and low costs, whiey deserues to be used widely.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2009年第15期1980-1982,共3页
Chinese Journal of Nosocomiology
关键词
抗菌药物
肝素
中心静脉双腔导管
预防感染
Antibiotics
Heparin
Dual-chamber central venous catheter
Prevention of infection
