Daschner F, Frank U
Abteilung Klinikhygiene, Universitätsklinik Freiburg.
Infusionstherapie. 1989 Oct;16(5):241-4.
This paper reviews recent data concerning epidemiology, pathogenesis, diagnosis, prevention and management of infectious complications of intravascular devices used for parenteral nutrition. Infectious complications of intravascular access for parenteral nutrition occur frequently. Any time there is a strong suspicion of a vascular access infection, it is important to draw blood cultures. The type of isolated organism may indicate the source of infection, e.g. the skin, hematogenous dissemination from another site or the infusate. Prevention of vascular access infection is preferable to treatment. Standardized insertion and maintenance techniques by specialized i.v. teams can substantially reduce the risk of infection. In-line filters or guidewires for changing catheters are of no proven benefit in decreasing infection risk, whereas transparent plastic dressings and multilumen lines increase infection risk. Treatment of established infection, e.g. removal of the catheter and/or antibiotic therapy, must be individualized for each patient on the basis of clinical presentation and causative organism.
本文综述了有关肠外营养用血管内装置感染并发症的流行病学、发病机制、诊断、预防及管理的近期数据。肠外营养血管通路的感染并发症很常见。任何时候，只要高度怀疑血管通路感染，进行血培养就很重要。分离出的微生物类型可能提示感染源，例如皮肤、来自其他部位的血行播散或输注液。预防血管通路感染优于治疗。由专业静脉输液团队采用标准化的置管和维护技术可大幅降低感染风险。用于更换导管的在线过滤器或导丝在降低感染风险方面并无已证实的益处，而透明塑料敷料和多腔导管会增加感染风险。对于已确诊的感染，例如拔除导管和/或进行抗生素治疗，必须根据每位患者的临床表现和病原体进行个体化处理。
