CAJ | 학술논문

目的探讨敷料不同更换频率对新生儿PICC导管穿刺口感染情况的影响,为选定适合新生儿的敷料更换频率提供理论依据.方法对95例实施PICC的新生儿进行前瞻性研究,随机分为3组,分别每3,5,7 d更换敷料,观察穿刺口感染情况并进行病原学检测,同时观察与敷料更换有关的并发症发生情况.结果每3d更换敷料组患儿31例,发生穿刺口感染3例占9.68%,每5 d更换敷料组患儿34例,发生穿刺口感染2例占5.88%,每7 d更换敷料组患儿30例,发生穿刺口感染5例占16.67%,3组穿刺口感染率比较无显著差异.10例穿刺口感染患儿的病原学检测8例阳性,阳性率80%,均为表皮葡萄球菌,其中2例为耐甲氧西林表皮葡萄球菌.每3 d更换敷料组患儿中4例出现表皮撕脱,每5,7 d更换敷料组患儿未出现表皮撕脱.结论建议新生儿PICC导管每7 d更换敷料1次,敷料潮湿、松动时及时更换.
목적 탐토부료불동경환빈솔대신생인PICC도관천자구감염정황적영향,위선정괄합신생인적부료경환빈솔제공이론의거.방법 대95례실시PICC적신생인진행전첨성연구,수궤분위3조,분별매3,5,7 d경환부료,관찰천자구감염정황병진행병원학검측,동시관찰여부료경환유관적병발증발생정황.결과 매3d경환부료조환인31례,발생천자구감염3례점9.68%,매5 d경환부료조환인34례,발생천자구감염2례점5.88%,매7 d경환부료조환인30례,발생천자구감염5례점16.67%,3조천자구감염솔비교무현저차이.10례천자구감염환인적병원학검측8례양성,양성솔80%,균위표피포도구균,기중2례위내갑양서림표피포도구균.매3 d경환부료조환인중4례출현표피시탈,매5,7 d경환부료조환인미출현표피시탈.결론 건의신생인PICC도관매7 d경환부료1차,부료조습、송동시급시경환.
Objective To explore the relationship between frequency of dressing change and PICC insertion site infection in neonates. Methods A prospective study was undertaken. 95 neonates were randomized into 3 groups, group 1 changed dressing every 3 days, group 2 changed dressing every 5 days, group 3 changed dressing every 7 days. Insertion site infection was observed and underwent pathogenic detection,complications associated with dressing change were also observed in all the 3 groups. Results 31 neonates were randomized to group 1 ,there were 3(9.68%)episodes of insertion site infection,34 neonates were randomized to group 2,there were 2(5.88%)episodes of insertion site infection, 30 neonates were randomized to group 3, there were 5(16.67%)episodes of insertion site infection. Rates of insertion site infection did not differ in the 3 groups.8 strains of staphylococcus epidermidis(2 of them were methicillin resistant staphylococcus epidermidis)were founded in 10 neonates who developed insertion site infection,positive rate was 80%. Skin excoriation occurred in 4 of 31 neonates in group 1,no neonates in the other two groups developed skin excoriation. Conclusions We suggest change dressing of neonatal PICC every 7 days,replace dressing if the dressing becomes damp or loosened at any time.