Skin Disinfection with 2% Chlorine Gluconate-Adine in Autologous Peripheral Hematopoietic Stem Cell Transplantation Patients

Background: Autologous peripheral blood hematopoietic stem cell transplantation is widely used in the treatment of malignant lymphoma. Patients are prone to infection during the transplantation immune deficiency period. There has been a lot of clinical research into how to better manage this period of vulnerability. Objective: This study aims to investigate the efficacy of 2% chlorhexidine gluconate (CHG) for skin disinfection in patients undergoing autologous hematopoietic stem cell transplantation (HSCT) and observe any adverse reactions. Methods: A total of 106 patients receiving autologous hematopoietic stem cell transplantation from November 2019 to December 2020 in our district were selected as the control group. From January 2021 to January 2022, 106 patients with autologous hematopoietic stem cells were included in the experimental group. The control group used the immersion bath method. The experimental group was treated with an improved scrub bath method (including 3M 2% chlorhexidine gluconate medical sanitary wipes to wipe the whole skin once). Results: The bacteria-carrying rate of the improved method (37.74%) was significantly better than that of the traditional soaking method (72.64%), and the difference was statistically significant (P Conclusion: The improved bath/wipe method has a significant positive effect on skin disinfection for patients undergoing HSCT.

2%氯己定醇液喷雾在小鼠腹部手术切口消毒效果的对比研究

目的:明确2%氯己定醇液喷雾消毒法在腹部手术切口中的消毒效果,以期为临床急腹症手术患者的腹部消毒方案提供新思路。方法:选用80只6~8周体重均一的健康C57BL/6雄性小鼠,随机分为4组:对照组、实验A组、实验B组、实验C组,每组20只。对照组采用2%氯己定醇液涂擦腹部3次消毒,实验A组用2%氯己定醇液喷洒2次,实验B组喷洒3次,实验C组喷洒4次,后行腹部正中切口模拟人体腹部手术过程。比较4组小鼠消毒时间、消毒液用量,消毒前后及手术前后切口边缘涂片和术后7 d腹腔灌洗液涂片培养的菌落数量,以及术后7 d内并发症发生情况。结果:实验A、B、C组均较对照组消毒时间短、消毒液用量少(P<0.01);消毒前1 min, 4组拟切口部位涂片培养菌落数比较差异无统计学意义(P>0.05);消毒后5 min,术中30 min、60 min,术后2 h、48 h切口涂片培养菌落数比较,实验A组较对照组明显增加(P<0.01),实验B、C组与对照组比较差异无统计学意义(P>0.05);实验A组较对照组术后7 d内并发症总发生例数明显增加(P<0.05),实验B、C组与对照组比较差异无统计学意义(P>0.05)。结论:2%氯己定醇液在小鼠腹部手术部位的消毒,喷雾3次和4次的方式都能达到与涂擦3次同样的消毒效果,同时缩短了消毒用时和节约消毒液用量。因此,2%氯己定醇液喷雾消毒法在以腹部手术为主的急诊手术患者消毒中有较大应用前景。

不同皮肤消毒剂对中心静脉导管相关血流感染发病率的影响

目的研究不同皮肤消毒剂对预防导管相关性血流感染(CRBSI)的影响。方法采用临床对照研究,比较2011年12月—2014年5月某三级甲等医院综合重症监护病房(ICU)患者中心静脉置管前使用复合型皮肤消毒剂、2%葡萄糖酸氯己定醇皮肤消毒剂患者CRBSI发病率差异。结果使用2%葡萄糖酸氯己定醇皮肤消毒剂的患者发生CRBSI 2例,其中革兰阴性菌(铜绿假单胞菌)和革兰阳性菌感染(金黄色葡萄球菌)各1例,CRBSI发病率为0.44‰(2/4 546);使用复合型皮肤消毒剂的患者发生CRBSI 22例,其中13例革兰阴性菌感染,7例革兰阳性菌感染,2例真菌感染,CRBSI发病率4.11‰(22/5 349),两组CRBSI发病率比较,差异有统计学意义(χ2=15.640,P<0.01)。结论中心静脉置管前使用2%葡萄糖酸氯己定醇的皮肤消毒效果更好,可以有效地降低ICU患者CRBSI发病率,值得临床优先应用。

浅谈PICC置管前后局部皮肤消毒对置管后相关并发症的影响

目的:分析总结护士在PICC置管前局部皮肤消毒准备在置管后相关并发症预防中的重要性。方法:选择160例需要留置PICC导管患者,随机分为观察组和对照组各80例,对照组置管时局部皮肤常规消毒,观察组在置管前先用2%CHG(洗必泰酒精消毒液)清洗PICC置管处局部皮肤再进行常规消毒,对比两组患者感染、局部静脉炎、置管时间、拔管的发生率。结论:PICC置管前、置管后维护中应用2%CHG清洗消毒穿刺局部皮肤可明显降低感染、静脉炎,拔管的发生率,并可延长置管时间。