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抗菌溶液在中心静脉导管护理中的作用。

The effect of antiseptic solution in central venous catheter care.

作者信息

Atahan K, Cokmez A, Bekoglu M, Durak E, Tavusbay C, Tarcan E

机构信息

1st Surgical Department, Ataturk Educational and Research Hospital, Izmir, Turkey.

出版信息

Bratisl Lek Listy. 2012;113(9):548-51. doi: 10.4149/bll_2012_123.

Abstract

AIM

Intravenous catheters have become one of the essential tools of modern medicine. Preventive measures taken while the catheter is being inserted or in place can provide a significant reduction in catheter-related infections and bacteremia/sepsis.This study aims to evaluate whether the patient's age and gender, the presence of malignancy and coexisting diseases, catheter duration, use of total parenteral nutrition solution, blood products, and antibiotics as well as antiseptics applied while attaching the central venous catheter (chlorhexidine and povidone-iodine) affect the development of catheter colonization and catheter-related bloodstream infections in patients with central venous catheters.

MATERIALS AND METHODS

Our study includes 50 cases which were admitted to İzmir Atatürk Training and Research Hospital, I. Surgical Clinic, hospitalized due to various reasons between the dates of January‒December 2010 and required catheter use. Patients were randomly assigned to one of the two operating rooms, in one of which the insertion site was disinfected with Poviiodeks® (10 % povidone-iodine) while in the other, (latter) Savlosol® (15 % cetrimide, 1.5 % Chlorhexidine-gluconate, ethanol) was used.

RESULTS

Among many factors examined in our study, only the use of clorhexidine versus iodine povidon in skin antisepsis was found to be statistically significant in the reduction of CRBSI and CC (for CRBSI p=0.022 and for CC p=0.047).

CONCLUSIONS

Our study concludes that skin antisepsis is the only determining factor in the prevention of blood infection and colonization due to central venous catheter application and the use of clorhexidine vs. povidon is proven to be statistically significant (Tab. 1, Ref. 27).

摘要

目的

静脉导管已成为现代医学的重要工具之一。在插入导管或导管留置期间采取预防措施可显著降低导管相关感染及菌血症/败血症的发生率。本研究旨在评估患者的年龄、性别、是否存在恶性肿瘤及并存疾病、导管留置时间、全胃肠外营养溶液、血液制品及抗生素的使用情况,以及在连接中心静脉导管时应用的防腐剂(氯己定和聚维酮碘)是否会影响中心静脉导管患者发生导管定植及导管相关血流感染。

材料与方法

我们的研究纳入了50例于2010年1月至12月期间因各种原因入住伊兹密尔阿塔图尔克培训与研究医院第一外科病房且需要使用导管的患者。患者被随机分配至两个手术室中的一个,其中一个手术室使用Poviiodeks®(10%聚维酮碘)对穿刺部位进行消毒,另一个手术室则使用Savlosol®(15%西曲溴铵、1.5%葡萄糖酸氯己定、乙醇)。

结果

在我们研究中所检测的诸多因素中,仅发现皮肤消毒时使用氯己定与聚维酮碘相比,在降低导管相关血流感染和导管定植方面具有统计学意义(导管相关血流感染p = 0.022,导管定植p = 0.047)。

结论

我们的研究得出结论,皮肤消毒是预防中心静脉导管应用导致血液感染和定植的唯一决定因素,并且已证明使用氯己定与聚维酮碘相比具有统计学意义(表1,参考文献27)。

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