血液透析患者股静脉置管导管感染病原菌及治疗效果分析

摘要

Objective To explore the pathogenic bacteria and therapy of catheter related infection in hemodialysis patients un -dergoing femoral vein cannulation. Methods Fifty-eight cases of hemodialysis patients with indwelling femoral vein catheters in our di -alysis center from April to Dec 2011 underwent blood bacterial culture and drug susceptibility test every week for ten weeks . Results Infection occurred in 8 cases( 13.79% ). The time between cannulation and infection was (50.25±13.76) days. Granmegative bacteria were the main pathogenic organisms. The infected patients got negative experimental results after treated by Vancomycin and Cefathiami - dine. Conclusion Blood culture of catheter bacteria is helpful for discovering early femoral vein catheter -related infection. The antibiotic therapy is an effective measure for catheter related infection.%目的 探讨血液透析(HD)患者股静脉置管后导管感染的病原菌及治疗措施.方法 选取本院城东病区 2011 年 4 ～12 月 58 例股静脉置管 HD 患者,分别在置管后每周行导管血细菌培养和药敏试验,共观察 10 周.全身感染者留取外 周血和导管血标本进行培养,给予经验性抗生素治疗,首选万古霉素、头孢硫脒行导管封管,血培养阳性者根据药敏结果 选用 抗生素,疗程为 1 周.结果 58 例股静脉置管患者中,8 例发生导管感染,感染率为 13.79%;距置管感染时间为(50.25±13.76)天,主要病原菌为革兰阳性菌.导管培养阳性者使用万古霉素或者头孢硫脒封管治疗 1 周后,导管培养复查均转为阴性.结论 导管血培养有助于早期发现 HD 患者股静脉导管感染,抗生素封管是治疗导管感染的有效措施.