發(fā)布時間：2019-08-01 17:46

【摘要】：目的探討心臟瓣膜替換術(shù)后不同處理措施對中心靜脈置管感染及IL-6、TNF-ɑ、應(yīng)激因子的影響,為降低中心靜脈置管后感染提供數(shù)據(jù)依據(jù)。方法選擇2014年3月-2016年1月醫(yī)院收治心臟瓣膜替換術(shù)患者208例,按入院順序?qū)⑵浞譃橛^察組與常規(guī)組,常規(guī)組100例給予穿刺部位處理,觀察組108例給予綜合處理,觀察兩組患者置管時間、置管期間相關(guān)感染發(fā)生情況;置管前后不同時間炎性因子及應(yīng)激因子水平情況;置管期間其它并發(fā)癥發(fā)生情況。結(jié)果觀察組總感染及全身感染率低于常規(guī)組(P0.05),兩組患者置管前應(yīng)激、炎性因子對比,差異均無統(tǒng)計學(xué)意義。觀察組置管后不同時間應(yīng)激因子丙二醛(MDA)水平低于同組置管前及常規(guī)組同期(P0.05),超氧化物歧化酶(SOD)水平低于同組置管前(P0.05),高于常規(guī)組同期(P0.05),置管后不同時間腫瘤壞死因子(TNF-ɑ)、白細胞介素-6(IL-6)水平均高于置管前(P0.05),低于對照組同期(P0.05),其它并發(fā)癥發(fā)生率對比差異無統(tǒng)計學(xué)意義。結(jié)論心臟瓣膜替換術(shù)給予綜合處理措施對中心靜脈置管相關(guān)感染具有預(yù)防作用,可降低炎性因子、氧化應(yīng)激因子水平,值得臨床推廣。
[Abstract]:Objective to investigate the effect of different management measures on central venous catheterization infection, IL-6,TNF- stress factor and stress factor after cardiac valve replacement, and to provide data basis for reducing central venous catheterization infection. Methods 208 patients undergoing cardiac valve replacement from March 2014 to January 2016 were divided into observation group and routine group according to the order of admission. 100 patients in routine group were treated with puncture site, 108 patients in observation group were given comprehensive treatment, the time of catheterization, the incidence of related infection during catheterization, the levels of inflammatory factors and stress factors at different time before and after catheterization, and other complications during catheterization were observed. Results the total infection and systemic infection rate in the observation group were lower than those in the routine group (P 0.05). There was no significant difference in stress and inflammatory factors between the two groups before catheterization. In the observation group, the level of malondialdehyde (MDA) (MDA) was lower than that before catheterization and the same period in routine group at different time after catheterization (P 0.05), and the level of SOD (SOD) was lower than that before catheterization (P 0.05), which was higher than that before catheterization (P 0.05). The levels of tumor necrosis factor (TNF-) and IL 6 (IL-6) at different time after catheterization were higher than those before catheterization (P 0.05). Compared with the control group (P 0.05), there was no significant difference in the incidence of other complications. Conclusion the comprehensive treatment of cardiac valve replacement has preventive effect on central venous catheterization related infection, and can reduce the level of inflammatory factors and oxidative stress factors, which is worthy of clinical promotion.
【作者單位】： 河南省人民醫(yī)院(鄭州大學(xué)人民醫(yī)院)心外科;
【基金】：2015年度河南省醫(yī)學(xué)科技攻關(guān)計劃項目(201503H010)
【分類號】：R654.2

【參考文獻】

相關(guān)期刊論文 前2條

1 郭舒婕;王曉敏;張瑜;張艷麗;;心臟術(shù)后中心靜脈導(dǎo)管感染的原因分析及干預(yù)措施的研究[J];中華醫(yī)院感染學(xué)雜志;2012年22期

2 安淑芬;芮晨;;心臟術(shù)后中心靜脈導(dǎo)管不同留置途徑感染的觀察及分析[J];中華全科醫(yī)學(xué);2012年06期

【共引文獻】

相關(guān)期刊論文 前7條

1 周丹;陶涼;劉彬;周宏;楊凱;;心臟外科患者中心靜脈導(dǎo)管感染的相關(guān)因素及預(yù)防對策研究[J];中華醫(yī)院感染學(xué)雜志;2017年07期

2 索莉娜;劉玉璽;董芳;張玲娟;張瑜;岳麗瑾;;心臟瓣膜替換術(shù)后不同處理措施對中心靜脈置管感染與IL-6和TNF-ɑ及應(yīng)激因子的影響[J];中華醫(yī)院感染學(xué)雜志;2017年05期

3 王小軍;;心臟術(shù)后患者中心靜脈置管感染調(diào)查分析[J];廣西醫(yī)科大學(xué)學(xué)報;2016年01期

4 杜守峰;師文華;孫君雋;;體外循環(huán)心臟直視術(shù)后中心靜脈導(dǎo)管感染的病原菌分布與危險因素分析[J];中華醫(yī)院感染學(xué)雜志;2015年02期

5 郭亞麗;;中心靜脈導(dǎo)管置管引流胸腔積液的護理[J];實用臨床醫(yī)藥雜志;2014年24期

6 宋翼;;分離封管與混合封管對預(yù)防中心靜脈導(dǎo)管相關(guān)性感染的效果比較[J];護士進修雜志;2014年23期

7 張惠霞;;中心靜脈導(dǎo)管封管技術(shù)臨床應(yīng)用進展[J];實用臨床醫(yī)藥雜志;2013年22期

【二級參考文獻】

相關(guān)期刊論文 前10條

1 潘春芳;竇英茹;鄭瑞強;史甜;;護理干預(yù)預(yù)防中心靜脈導(dǎo)管相關(guān)性感染的效果評價[J];中華醫(yī)院感染學(xué)雜志;2012年07期

2 吳本清;林真珠;李志光;馬曉利;;新生兒經(jīng)外周置入中心靜脈導(dǎo)管相關(guān)感染研究[J];中華全科醫(yī)學(xué);2011年07期

3 安淑芬;張楠;郭楠;宋書田;周\娢，

本文編號：2521906