Application Value of Medical Chlorhexidine Gluconate Cotton Tablets in Hemodialysis Catheter Nursing
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摘要:
目的 探讨使用医用葡萄糖酸洗必泰棉片护理血液透析中心静脉导管接头，对降低导管相关感染事件的临床应用价值。 方法 选取2018年1月至2020年12月云南省第三人民医院、昆明市第三人民医院血液透析室接受中心静脉置管进行透析治疗的90例患者作为研究对象，根据对血透导管接头不同的消毒方式，将90位患者随机分为观察组和对照组各45例。对照组实施常规的碘伏棉签消毒导管螺纹接头，观察组使用医用葡萄糖酸洗必泰棉片对导管螺纹接头擦拭消毒。观察2组患者血液透析置管导管相关感染发生率及护理质量评分。 结果 对照组发生导管相关感染13例，发生率28.9%，观察组感染3例，发生率6.7%，差异有统计学意义（P < 0.05）；护理质量评分观察组（91.96±2.76）分，对照组（87.16±2.99）分，差异有统计学意义（ P < 0.05）。 结论 使用医用葡萄糖酸洗必泰棉片擦拭消毒血液透析导管螺纹接头能降低导管相关感染发生率，提升护理操作、感染防控质量，有临床应用价值。 Abstract:Objective To explore the clinical value of using medical chlorhexidine gluconate cotton tablets to nursing the central venous catheter connector of hemodialysis and reducing catheter-related infection. Methods 90 patients who received central venous catheterization in the hemodialysis room of Yunnan Third People’ s Hospital and Kunming Third People’ s Hospital from January 2018 to December 2020 were selected as the research objects. According to different disinfection methods of hemodialysis catheter connectors, 90 patients were randomly divided into observation group and control group, with 45 cases in each group. Routine iodophor cotton swabs were used to disinfect the catheter threaded joints in the control group, and chlorhexidine gluconate cotton tablets were used to wipe and disinfect the catheter threaded joints in the observation group. The incidence of catheter-related infection and nursing quality score of hemodialysis patients in the two groups were observed. Results There were 13 cases of catheter-related infection in the control group （28.9%） and 3 cases in the observation group （6.7%）. The difference was statistically significant （P < 0.05）; The score of nursing quality was 91.96±2.76 in the observation group and 87.16±2.99 in the control group （ P < 0.05）. Conclusion Using medical chlorhexidine gluconate cotton tablet to wipe and disinfect the threaded joint of hemodialysis catheter can reduce the incidence of catheter-related infection, improve the quality of nursing operation and infection prevention and control, and has clinical application value. -
表 1 2组患者基础资料比较[n（%），（
$ {\bar{{x}}} \pm s$ ）]Table 1. Comparison of basic data of patients between the two groups [n（%），（
$ {\bar{{x}}} \pm s$ ）]组别 n 性别 年龄（岁） 置管时间（月） 置管部位 男 女 颈内静脉 股静脉 观察组 45 28（48.3） 17（53.1） 43.24 ± 12.29 5.13 ± 1.46 40（88.89） 5（11.11） 对照组 45 30（51.7） 15（46.9） 46.69 ± 10.47 5.20 ± 1.62 42（93.33） 3（6.67） χ2值 0.194 −1.433 −0.205 0.137 P值 0.660 0.155 0.838 0.711 
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表 2 2组患者透析导管相关感染发生率比较[n（%）]
Table 2. Comparison of the incidence of dialysis cathter-related infections between the two groups [n（%）]
组别 n 导管出口感染 导管隧道感染 导管相关性血流感染 感染总例次 观察组 45 2（4.4） 1（2.2） 0（0.0） 3（6.7） 对照组 45 6（13.3） 6（13.3） 1（2.2） 13（28.9） χ2 1.235 2.478 — 7.601 P 0.266 0.115 1.000a 0.006 注：a表示Fisher精确检验。
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表 3 2组患者护理质量检查评分比较（
$ {\bar{{x}}}\pm s $ ）Table 3. Comparison of nursing quality examination scores between the two groups （
$ {\bar{{x}}}\pm s $ ）组别 护理安全 病区管理 消毒隔离 护理操作 感染防控 总分 观察组 18.27 ± 1.41 17.73 ± 1.66 18.78 ± 0.95 19.29 ± 1.34 17.89 ± 1.15 91.96 ± 2.76 对照组 17.98 ± 1.45 18.09 ± 1.61 18.49 ± 1.16 16.44 ± 1.37 16.16 ± 1.61 87.16 ± 2.99 t 0.959 −1.033 1.292 9.933 5.875 7.906 P 0.340 0.304 0.200 < 0.001 < 0.001 < 0.001
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