新生儿126例脐静脉插管末端细菌培养的临床分析

The clinical analysis of 126 neonatal umbilical venous catheter tip culture

目的通过分析脐静脉插管(UVC)末端细菌培养的结果,探讨UVC与新生儿感染之间的关系。方法对126例实行UVC的新生儿按照不同的治疗护理方式分类,并将UVC末端培养和血培养结果进行比较。结果17例新生儿有感染症状,血培养、UVC末端培养及两者共同阳性例数分别为24、19和15例,早产儿的培养阳性率明显高于足月儿。UVC末端培养阳性率与年龄(t=2.344,P=0.021)、UVC置留时间(t=2.462,P=0.015)、脐部纱布覆盖(t=2.460,P=0.015)有关,与经UVC的输液成分和是否通过UVC抽血对培养的阳性率无明显影响。结论在对患儿实施脐静脉插管的过程中,特别是对于早产儿,缩短插管的时间、暴露脐部以及操作时严格消毒都有利于减少感染的发生。

Objective To discuss the relationship between umbilical venous catheter （UVC） tip culture results and neonatal infection. Methods One hundred and twenty-six neonates who admitted with UVC were classified by different treating and nursing methods. UVC tip culture results were studied. Results Seventeen neonates had symptoms of infection. The number of culture positive in blood, UVC tip, and both was 24, 19, and 15. The positive rate was much higher in premature infants. UVC tip culture positive had relations with age （t =2. 344,P =0. 021 ）, duration of UVC （t =2. 462,P =0. 015）, local gauze utilizing （t = 2. 460 ,P = 0. 015 ）, but it did not relate to the contents of infusion fluids （t = 0. 094, P = 0. 926） and blood sample taking from UVC （t = 0. 018, P = 0. 986 ）. Conclusions Sterilized procedure and withdraw UVC as early as possible while indicated are important for the reducing of infection during UVC course.