目的：探索磷霉素抗生素锁技术(antibiotic lock technology，ALT)在治疗导管相关感染中的作用及给药方式对临床疗效的影响。方法：选取43例患者作为研究对象，均为2012年1月至2014年4月在九江学院临床医学院附属医院治疗的导管相关感染的血透患者，将其随机分为A(n=14)、B(n=7)、C(n=8)、D(n=14)四组，观察各组治疗效果。A组患者单药每日2次，B组患者单药每日1次，C组患者联合用药(磷霉素+单药)每日各1次，D组患者为未封管处理。结果：①导管感染的前四位细菌共41例，占95.3%，依次为金黄色葡萄球菌、表皮葡萄球菌、除表皮的凝固酶阴性葡萄球菌、大肠埃希菌，磷霉素的敏感率均较高，分别为82.3%、71.4%、73.3%、96.5%；②不同的给药方式影响治疗效果。联合给药组血培养转阴时间最短(P0.05)。结论：磷霉素可作为是早期用药的选择，磷霉素锁技术中的联合用药能提高治疗效果，血培养转阴时间及体温下降速度可作为疗效观察指标。%Objective: To explore the effect of the antibiotic lock technique (ALT) in the treatment of catheter related infection and its effect on the clinical efficacy.Methods: 43 catheter-related infections patients were selected as the research object, from January 2012 to April 2014 in Jiujiang University Hospital for the treatment of hemodialysis, and randomly divided into A (n=14), B (n=7), C (n=8), D (n=14) four groups, the therapeutic effects were observed. Patients in group A were treated with single medicine 2 times a day, 1 times a day in group B, patients in group C were treated with combination therapy (P+1), D group was not sealed.Results: The results of catheter infection four bacteria were 41 cases, accounting for 95.3%, followed by Staphylococcus aureus, Staphylococcus epidermidis, in addition to the epidermis of coagulase negative staphylococcus, Escherichia coli, fosfomycin sensitive rate were higher, respectively 82.3%, 71.4%, 73.3%, 96.5%. Blood culture conversion in combination group is the shortest (P0.05).Conclusion: Fosfomycin as early drugs of choice, in combination lock technology improve the therapeutic effect. Blood culture negative time and temperature drop speed can be used as the efficacy index.
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