通过严格的导管限制抗生素封管液方法，采用抗生素封管技术成功预防带 cuff 的血液透析导管相关感染。
Successful prevention of cuffed hemodialysis catheter-related infection using an antibiotic lock technique by strictly catheter-restricted antibiotic lock solution method.
作者信息
Zhang Ping, Yuan Jing, Tan Huizhen, Lv Rong, Chen Jianghua
机构信息
Kidney Disease Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China.
出版信息
Blood Purif. 2009;27(2):206-11. doi: 10.1159/000197560. Epub 2009 Jan 29.
BACKGROUND
Catheter-related infection (CRI) is associated with increased all-cause mortality and morbidity in hemodialysis patients and may be reduced by using antimicrobial lock solutions. But the safety of long-term use of antimicrobial lock still needs to be defined.
METHODS
Patients with a new inserted permanent tunneled cuffed hemodialysis catheter were randomly assigned to an antibiotic lock solution of gentamicin (4 mg/ml) heparin (G group) or heparin alone (H group).
RESULTS
A total of 140 patients were enrolled in this study. CRI rates were 0.06/1,000 catheter-days for the G group versus 0.67 in the H group (p = 0.014). The risk of CRI was 10.54 higher in patients with a heparin-alone locked catheter (p = 0.025) than that with gentamicin. The serum-measured gentamicin levels were very low.
CONCLUSIONS
Gentamicin lock solution reduces CRI and improves catheter survival rates in hemodialysis patients. It is relatively safe in strictly catheter-restricted antibiotic lock solution therapy.
背景
导管相关感染（CRI）与血液透析患者全因死亡率和发病率的增加相关，使用抗菌封管液可能会降低其发生率。但长期使用抗菌封管液的安全性仍有待明确。
方法
将新插入永久性带隧道涤纶套血液透析导管的患者随机分为庆大霉素（4mg/ml）肝素抗生素封管液组（G组）或单纯肝素组（H组）。
结果
本研究共纳入140例患者。G组的CRI发生率为0.06/1000导管日，而H组为0.67（p = 0.014）。单纯肝素封管的患者发生CRI的风险比使用庆大霉素的患者高10.54倍（p = 0.025）。血清检测的庆大霉素水平非常低。
结论
庆大霉素封管液可降低血液透析患者的CRI并提高导管存活率。在严格的导管限制抗菌封管液治疗中相对安全。
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