应用抗生素锁技术预防婴幼儿输液港感染的随机对照研究

Randomized controlled trial of application of antibiotic lock technique in preventing implantable venous access port-related infection in infants

目的探索抗生素锁技术在预防婴幼儿肿瘤患者出现植入式静脉输液港相关感染并发症中的效果。方法选取首都医科大学附属北京世纪坛医院60例确诊神经系统恶性肿瘤并接受手术放置植入式静脉输液港的婴幼儿患者,进行随机对照研究,实验组30例患儿在术后预防性使用抗生素锁技术封管,对照组30例患儿单纯使用肝素盐水封管,按严格随访计划观察所有患儿在术后1个月中是否出现感染并发症,比较两组间的差异并寻找导致感染并发症的危险因素。结果两组患儿一般情况的组间比较差异无统计学意义(P<0.05),预防性使用抗生素锁技术组的患儿术后感染率为3.33%,而对照组患儿的术后感染率为13.33%,两组比较差异无统计学意义(P=0.353);分析后未发现导致感染并发症出现的独立危险因素。结论预防性应用抗生素锁技术可能会在一定程度上减少婴幼儿肿瘤患者植入式静脉输液港相关感染并发症的发生率,但需要后续扩大样本量深入研究来证实其临床效果。

Objective This research was designed to explore the effect of antibiotic lock technique(ALT)in preventing implantable venous access port(IVAP)-related infection in infants with malignant tumors.Methods Sixty infants with neurological malignant tumors were underwent implantation of IVAP by the same surgical team in our hospital.They were randomly divided into two groups.Prophylactic cefuroxime mixed with heparin saline was used as the seal liquid in 30 infants after the implantation,and the same volume of heparin saline was applied in the other 30 infants.All the patients were followed to observe whether there was IVAP-related infection within one month.The differences between two groups were compared and the risk factors for IVAP were investigated.Results The general characteristics had no significant difference between two groups.Only one infant got infection in the ALT group(3.33%),while four infants developed infection in the control group(13.33%).Although the difference between two groups was not statistically significant(P=0.353).No significant independent risk factor for IVAP was revealed by the present study.Conclusion The application of ALT in the IVAP implantation might be an effective method to decrease the infection rate in infants with malignant tumors to a large extent,but it still needs a large sample of research to confirm the clinical effect.