運用抗菌性敷料於中央靜脈導管留置病童感染發生率之成效

Effect of Chlorhexidine Antibacterial Dressing for the Children with a Central Venous Catheter

黃鈴雅(Ling-Ya Huang) ； 沈青青(Ching-Ching Sheng) ； 曾佳雯(Chia-Wen Tseng) ； 龔怡萍(Yi-Ping Kung) ； 謝枝華(Chih-Hwa Hsieh)

《榮總護理》 37卷2期 (2020/06) Pp. 110-119

https://doi.org/10.6142/VGHN.202006_37(2).0001

摘要

本研究旨在探討介入「2% Chlorhexidine抗菌性敷料」降低中央靜脈導管相關血流感染及靜脈炎發生率之成效。採隨機對照研究設計，研究對象為北部某醫學中心0－18歲有中央靜脈導管留置之住院病童，實驗組及對照組各收案30位。實驗組以2% Chlorhexidine抗菌性敷料作為介入性措施，對照組採常規照護。研究結果顯示，無論實驗組或對照組，其中央靜脈導管相關血流感染發生率均為10%，且在體溫（p＞ .999）及血液細菌培養（p= .711）兩項感染相關指標、以及靜脈炎發生率（p= .278）、住院天數（p= .872）、管路留置天數（p= .075）皆未達統計上顯著差異；惟發現實驗組雖多為入院行周邊血液幹細胞移植之腫瘤病童、且管路留置天數較對照組多出12.06天，但其感染率並無顯著增加。故建議日後若照護需長期留置中央靜脈導管的病童，可提供抗菌性敷料，期維護病童安全。

關鍵字

兒童 ； Chlorhexidine抗菌性敷料 ； 中心靜脈導管相關感染 ； 靜脈炎

並列摘要

The purpose of this study was to investigate the effectiveness of ＂2% Chlorhexidine antibacterial dressing＂ to reduce the incidence of central venous catheter-related bloodstream infections and phlebitis. The study design was a randomized controlled trial. The subjects were hospitalized child with a central venous catheter indwelling from 0-18 years old in a medical center in the north of Taiwan. Each of experimental group and control group with 30 cases. The experimental group used 2% Chlorhexidine antibacterial dressing as an intervention, and control group received routine nursing care. According to the results, the incidence of central venous catheter-related bloodstream infection both of two groups were 10%, and body temperature (p＞ .999), blood bacterial culture (p= .711) , incidence of phlebitis (p= .278), length of stays (p= .872), and days of catheter indwelling (p= .075) did not reach significant differences between two groups. Although most of them are children with cancer who were admitted to the hospital for peripheral blood stem cell transplantation, but the days of catheter indwelling of experimental group were 12.06 days than control group. Recommendation based on the results of the study, we can provide 2% Chlorhexidine antibacterial dressing for the children with long-term implementation of central venous catheter.

並列關鍵字

children ； chlorhexidine antibacterial dressing ； central venous catheter-related infections ； phlebitis

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