透明敷料不同更换频率对新生儿导管相关性感染影响研究

Influence of replacement frequency of transparent dressing on catheter-related infections in neonates

目的探讨透明敷料不同更换频率对新生儿经外周静脉置入中心静脉导管术(PICC)导管相关性感染的影响,探讨降低新生儿导管相关性感染发生率。方法选取2009年1月-2013年1月300例留置PICC导管的新生儿为研究对象,并随机分为A、B、C 3组,每组各100例,A组更换敷料频率为每3d1次,B组更换敷料频率为每5d1次,C组更换敷料频率为每7d1次,对比分析3组新生儿的感染情况,采用SPSS17.0进行统计分析。结果 A、B、C 3组的穿刺部位感染率分别为12.0%、10.0%和14.0%;3组的导管病原菌定植发生率分别为7.0%、6.0%和5.0%;导管相关性血流感染发生率分别为1.0%、2.0%和1.0%,3组新生儿各项指标比较,差异均无统计学意义。结论新生儿PICC导管的敷料更换频率每7d1次较为合理,可减轻护理人员的工作量,又能有效降低感染率,注意敷料潮湿、松动时,应及时更换。

OBJECTIVE To explore the influence of replacement frequency of transparent dressing on peripherally inserted central catheter （PICC）‐related infections in neonates so as to reduce the incidence of catheter‐related in‐fections in the neonates .METHODS A total of 300 neonates who underwent the PICC indwelling in the hospital from Jan 2009 to Jan 2013 were recruited as the study objects and randomly divided into three groups （group A ,B and C） ,with 100 cases in each ;the dressing was replaced once per 3 days in the group A ,once per 5 days in the group B ,once per 7 days in the group C ;the incidence of the infections was observed and compared between the three groups of neonates ,and the statistical analysis was performed by using SPSS17 .0 software .RESULTS The incidence of the puncture site infections was 12 .0% in the group A ,10 .0% in the group B ,14 .0% in the group C .The incidence of the colonization of pathogens on catheters was 7 .0% in the group A ,6 .0% in the group B , 5 .0% in the group C .The incidence of the catheter‐related bloodstream infections was 1 .0% in the group A , 2 .0% in the group B ,1 .0% in the group C ;as compared with the indicators ,there were no statistically signifi‐cant differences between the three groups of neonates .CONCLUSION The once per 7 days is the reasonable re‐placement frequency of PICC dressing for the neonates ,it can not only reduce the workload of nursing staff but al‐so effectively reduce the infection rate .The dressing should be replaced in a timely manner when it is wet and loose .