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‰（2／4546）；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‰（22／5349），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。%Objective To study the effect of different skin disinfectant on the prevention of catheter-related blood-stream infection (CRBSI).Methods Clinical control study was used to compare the difference in incidences of CRB-SI in patients who used compound skin disinfectant and 2% chlorhexidine gluconate (CHG)alcohol skin disinfectant before central venous catheterization in the intensive care unit of a tertiary first class hospital between December 2011 and May 2014.Results Among patients who used 2% CHG alcohol skin disinfectant,2 had CRBSI,one was gram-negative bacterial infection (Pseudomonas aeruginosa ),and the other was gram-positive bacterial infection (Staphylococcus aureus ),incidence of CRBSI was 0.44‰(2/4 546);among patients who used compound skin disin-fectant,22 had CRBSI,13 were gram-negative bacterial infection,7 were gram-positive bacterial infection,and 2 were fungal infection,incidence of CRBSI was 4.11 ‰(22/5 349),incidence of CRBSI between two groups of pa-tients was significantly different (χ2 =15.640,P <0.01).Conclusion 2% CHG alcohol skin disinfectant has a bet-ter effect on the skin disinfection before central venous catheterization,which can effectively reduce the incidence of CRBSI in ICU patients,and is worthy of priority clinical application.
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