妇科肿瘤患者中心静脉置管相关感染的预防研究

Prevention programs of central venous catheter related infections in patients with gynecologic cancer

目的探讨妇科肿瘤患者中心静脉置管相关感染的预防方案研究,以期达到有效降低患者感染率以及感染并发症目的。方法选取2012年6月-2014年6月在医院妇科肿瘤住院治疗的需要中心静脉置管患者200例,根据数字表法将所有患者随机分为对照组和观察组,各100例;对照组给予单纯肝素钠封管处理,观察组患者给予肝素钠和头孢拉定联合封管,比较两组患者的导管相关的感染率,病原菌的分布及并发症的情况,数据采用SPSS 19.0软件进行统计分析。结果观察组患者感染率为1.00%、对照组为9.00%,差异有统计学意义(P<0.05);两组患者的白细胞计数以及中性粒细胞比例的差异无统计学意义;感染菌分类中对照组患者的大肠埃希菌的株数显著的高于观察组,差异均有统计学意义(P<0.05),两组患者表皮葡萄球菌和金黄色普通球菌检出比例差异无统计学意义;观察组患者发生静脉炎和血栓显著低于对照组,差异有统计学意义(P<0.05)。结论妇瘤科患者中心静脉置管后采用头孢拉定和肝素钠联合封管可以有效的降低患者感染率,降低患者感染相关的并发症,值得临床推广。

OBJECTIVE To investigate the prevention measures for central venous catheter related infections in pa- tients with gynecologic tumor, so as to reduce the infection rate and the infection complications. METHODS From Jun. 2012 to Jun. 2014, 200 patients with central venous catheter were randomly divided into control group and observation group with 100 cases in each group. The control group was treated with pure heparin sodium and then was sealed and the observation group received both heparin sodium and cefradine and sealed later. The catheter re- lated infection rates of the two groups were compared. The distribution of pathogens and the status of complica- tions were analyzed and compared. SPSS was adopted for statistical analysis. RESULTS The infection rates of the observation group （1.00%） was significantly lower than the control group （9.00%） （P〈0.05） ; the white blood cell count and neutrophil cell proportion of the two groups were almost similar. The number of strains of Esche- richia coli was significantly larger in the control group than in the observation group, and there was significant difference （P〈0.05）. The differences of the proportion of staphylococcus epidermidis and Staphylococcus au- reus detected in the two groups were not significant. However, patients in the control group were easier to get phlebitis and thrombosis than the observation group, and the difference was significant （P^0.05）. CONCLUSION Combination of heparin sodium and cefradine can effectively reduce the infection rates in patients with central ve- nous catheter and help to decrease the related complications hence is worthy to be promoted in clinical practice.