氯己定湿巾在肝移植术后患者擦浴中的应用及效果评价

Application and effect evaluation of clohexidine wipes in patients with liver transplantation

目的探讨氯己定湿巾在肝移植术后患者擦浴中的应用及预防感染的效果.方法选取2017年1月至2018年12月,在中山大学附属第一医院接受同种异体原位肝移植手术,术毕转入本院重症医学科的患者共279例为研究对象,其中2017年1-12月的肝移植术后患者145例为对照组,采用0.01%的苯扎氯铵稀释液擦浴;2018年1-12月的肝移植术后患者134例为干预组,采用2%葡萄糖酸氯己定湿巾擦浴,比较2组患者医院感染率、感染例次率、多重耐药菌感染率、擦浴耗费时间、不良反应发生率.结果对照组在ICU期间的医院感染率为20.00%(29/145),感染例次率为37.93%(55/145),多重耐药菌感染率为25.52%(37/145),干预组分别为11.19%(15/134)、24.63%(33/134)、14.93%(20/134),差异有统计学意义(χ^2=4.065、5.709、4.806,P<0.05).2组患者擦浴耗费时间比较,对照组为(16.70±1.42)分,干预组为(14.07±1.53)分,差异有统计学意义(t=9.637,P<0.01).2组患者均无出现消毒剂过敏等不适症状.结论2%葡萄糖酸氯己定湿巾在肝移植术后患者擦浴中应用效果良好,显著降低了医院感染率,节省了擦浴时间.

Objective To investigate the application of clohexidine wipes in patients after liver transplantation and the effect of infection prevention.Methods A total of 279 patients who received orthotopic liver transplantation in the first affiliated hospital of sun yat-sen university from January 2017 to December 2018 and were transferred to the intensive care department of our hospital after the surgery were selected as subjects.Among them,145 patients who received liver transplantation between January and December 2017 were selected as the control group.From January to December,2018,134 patients after liver transplantation were enrolled as the intervention group,and were treated with clohexidine 2%gluconate wet wipes,and the hospital infection rate,infection rate,multiple drug-resistant bacteria infection rate,bath time consumption,and adverse reaction rate were compared between the two groups.Results The hospital infection rate of the control group was 20.00%(29/145),the infection rate of patients was 37.93%(55/145),the infection rate of multiple drug-resistant bacteria was 25.52%(37/145),and the infection rate of the intervention group was 11.19%(15/134),24.63%(33/134),14.93%(20/134).The differences were statistically significant(χ^2=4.065,5.709,4.806,P<0.05).The bath time of the control group was(16.70±1.42)minutes,and the intervention group was(14.07±1.53)minutes.Compared with the control group,the bath time of the intervention group was saved,and the difference was statistically significant(t=9.637,P<0.01).No discomfort symptoms such as disinfectant allergy were found in both groups.Conclusion The application of clohexidine 2%gluconate wet wipes in the wiping bath of patients after liver transplantation had a good effect,significantly reducing the hospital infection rate,saving the time of wiping bath.