Jones L L, Tweedy L, Warady B A
Pediatric Dialysis Program, Children's Mercy Hospital, Kansas City, Missouri, USA.
Adv Perit Dial. 1995;11:302-5.
The optimal approach to catheter exit-site care and catheter design in terms of catheter-related infections (e.g., exit-site infections, peritonitis) in children remains elusive. We retrospectively compared the incidence of exit-site infections and peritonitis in 33 pediatric peritoneal dialysis patients who used one of three exit-site care/catheter combinations. The catheters used were single-cuffed, curled Tenckhoff (T), and double-cuffed Swan neck (SN). Exit-site care included either povidone-iodine (PI) or chlorhexidine (CHL) as cleansing agents. Our data suggest that the use of chlorhexidine versus povidone-iodine is associated with a significant decrease (p < 0.05) in the frequency of catheter exit-site infections in children. The use of the Swan-neck double-cuffed catheter does not appear to have any further impact on the frequency of exit-site infections. Neither the use of chlorhexidine nor Swan neck catheters had an effect on our peritonitis rate. Our review suggests that a prospective evaluation of a chlorhexidine-based exit-site care regimen in children should be encouraged.
就儿童导管相关感染（如出口部位感染、腹膜炎）而言，导管出口部位护理及导管设计的最佳方法仍不明确。我们回顾性比较了33例使用三种出口部位护理/导管组合之一的儿科腹膜透析患者的出口部位感染和腹膜炎发生率。所使用的导管为单袖口卷曲Tenckhoff（T）导管和双袖口鹅颈（SN）导管。出口部位护理使用聚维酮碘（PI）或洗必泰（CHL）作为清洁剂。我们的数据表明，与聚维酮碘相比，使用洗必泰可使儿童导管出口部位感染频率显著降低（p<0.05）。使用鹅颈双袖口导管似乎对出口部位感染频率没有进一步影响。使用洗必泰和鹅颈导管均未对我们的腹膜炎发生率产生影响。我们的综述表明，应鼓励对儿童基于洗必泰的出口部位护理方案进行前瞻性评估。
