林可霉素联合肝素钠封管预防ICU中心静脉导管感染的临床研究

Clinical effect of lincomycin combined heparin for tube sealing on prevention of central venous catheter-related infections in ICU

目的研究林可霉素联合肝素钠封管对于预防ICU中心静脉导管感染的临床应用,以降低ICU中心静脉导管感染率。方法选取2012年9月-2013年11月ICU进行中心静脉导管置管的住院患者随机分为试验组和对照组,各63例,试验组患者给予林可霉素联合肝素钠封管,对照组患者给予生理盐水与肝素钠封管,对比两组患者导管置管部位及置管后感染率、病原菌分布及药物不良反应发生率。结果中心静脉导管术以股静脉置管为主,感染率与置管部位有关,其中股静脉置管发生感染的概率最高,股静脉置管感染率试验组为11.76%、对照组感染率为36.11%,两组不同置管部位的感染率及总感染率差异均有统计学意义(P<0.05);感染患者的主要病原菌是革兰阳性菌,试验组导管血培养阳性率为16.67%、对照组为61.11%,两组比较差异有统计学意义(P<0.05);试验组不良反应发生率为7.94%、对照组为11.11%,两组比较差异无统计学意义。结论林可霉素联合肝素钠封管对于预防ICU中心静脉导管感染的临床应用效果良好。

OBJECTIVE To explore the clinical effect of lincomycin combined with heparin for tube sealing on prevention of central venous catheter-related infections in ICUs so as to reduce the incidence of central venous catheter-related infections in the ICUs.METHODS The hospitalized patients who underwent central venous catheterization in the ICUs from Sep 2012 to Nov 2013 were enrolled in the study and randomly divided into the experimental group and the control group,with 63 cases in each group;the experimental group was treated with lincomycin combined with heparin for tube sealing,while the control group was given the normal saline and heparin for tube sealing;the catheterization sites,incidence of infections,distribution of pathogens,and incidence of adverse reactions were observed and compared between the two groups.RESULTS The femoral vein catheterization was the predominant central venous catheterization;the infection rate was associated with the catheterization sites,the incidence of infections was the highest in the patients who underwent the femoral vein catheterization;the incidence of femoral vein catheter-related infections was 11.76%in the experimental group,36.11%in the control group,there was significant difference in the infection rate or the total infection rate of the different infection sites between the two groups（P〈0.05）.The gram-positive bacteria were dominant among the pathogens causing the infections,the positive rate of the catheter blood culture was 16.67% in the experimental group,61.11% in the control group,there was significant difference between the two groups（P〈0.05）.The incidence of adverse reactions was7.94%in the experimental group,11.11%in the control group,there was no significant difference between the two groups.CONCLUSIONLincomycin combined with heparin for tube sealing can achieve significant clinical effect on prevention of the central venous catheter-related infections in the ICUs.