新生儿,脐静脉置管,核查表单,导管相关性血流感染," /> 新生儿,脐静脉置管,核查表单,导管相关性血流感染,"/> Neonate, Umbilical vein catheterization, Checklist, Catheter-related bloodstream infection,"/> <span style="line-height:2;font-size:14px;">新生儿脐静脉置管核查表单在降低导管</span><span style="line-height:2;font-size:14px;">相关血流感染率中的作用</span>
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发育医学电子杂志  2020, Vol. 8 Issue (1): 67-71    DOI: 10.3969/j.issn.2095-5340.2020.01.012
  围产医学   论著 |新生儿 |
新生儿脐静脉置管核查表单在降低导管相关血流感染率中的作用
李书芳 张艳 李艳民 魏燕云 孙园园 郭志灵
邯郸市第一医院 新生儿科,河北 邯郸 056001
Effect of umbilical vein catheterization checklist on reducing catheter-related bloodstream infection rate in neonates
LI Shu-fang, ZHANG Yan, LI Yan-min, et al
Department of Neonatology, Handan First Hospital, Hebei Handan 056001, China
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摘要 【摘要】 目的  评价新生儿脐静脉置管核查表单对降低导管相关性血流感染(catheter-related blood stream infection,CRBSI)的干预效果。 方法 2014 年3 月1 日至2019 年3 月1 日,在邯郸市第一医院新生儿科住院的患儿中,纳入脐静脉置管的患儿为研究对象,随机分为观察组(208 例)与对照组(210 例),均在入院后24 h 内完成脐静脉置管,并采用统一的拔管指征。观察组参考手术核查表单,制定脐静脉置管的核查表单,记录患儿的适应证与禁忌证、置管前准备和评估、置管中手术核查、术后导管维护、导管拔除等内容;对照组按常规方法管理。CRBSI 感染率指每1 000 个中心静脉导管日的CRBSI 感染数。采用t 验、χ2 检验、二项分布的z 检验进行统计学分析。 结果  观察组与对照组患儿的入院日龄、出生时胎龄、性别、置管时间、患儿来源比较,差异均无统计学意义(P>0.05)。观察组无一例发生物品准备不足;对照组中,56 例在手术过程中发现缺少物品。观察组中3 例无操作前患儿评估的签字记录,对照组中102 例病历书写中未记录患儿评估情况。观察组中记录到23 例抽回血慢,12 例调整置管长度;对照组病历及护理表格中未记录操作过程中的意外情况。观察组与对照组的总置管天数分别为2 082 d 与2 103 d,感
染例数分别为1 与7 例,CRBSI 感染率分别为0.48 与3.32 人次/ 千导管日,观察组CRBSI 感染率低于对照组(z=2.10,P<0.05)。 结论 在新生儿脐静脉置管过程中采用核查表单,有助于术者和后期维护人员保持警惕,消除安全隐患,预防错误,持续改进,保障患儿安全,有效降低CRBSI 感染率。
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关键词:  新生儿')" href="#">新生儿  脐静脉置管  核查表单  导管相关性血流感染    
Abstract: 【Abstract】 Objective To evaluate the interventional effect of neonatal umbilical vein catheterization checklist on reducing the incidence of catheter-related blood stream infection (CRBSI). Methods From March 1, 2014 to March 1, 2019, among the children admitted to the neonatal department of the First Hospital of Handan City, children with umbilical vein catheterization were included in the study, and they were randomly divided into the observation group (208 cases) and the control group (210 cases). Umbilical vein catheterization was completed within 24 hours after admission, and unified indications for extubation
were used. Refering to the operation checklist, we developed a checklist for umbilical vein catheterization for the observation group, and recorded the indications and contraindications of the children, preparation and evaluation of the catheterization, surgical check during the catheterization, postoperative cathetermaintenance, and catheter removal. Control group were managed in the usual way. CRBSI infection rate means the number of CRBSI infection cases per 1 000 days of central venous catheter. Statistical analysis was performed t test, χ2 test, and binomial z test. Results There was no significant difference in the age of admission, gestational age at birth, gender, time of intubation, and source of the children between the observation group and the control group (P>0.05). In the observation group, none of the items were underprepared; in the control group, 56 cases were found to be missing items during surgery. Three patients in the observation group had no pre-operation evaluation records, while 102 patients in the control group did not record their evaluations. In the observation group, 23 patients with slow withdrawal of blood were recorded, and 12 patients were adjusted the length of the catheterization; the control group's medical
records and the nursing form did not record any accidents during the operation. The total number of catheterization days in the observation group and the control group were 2 082 days and 2 103 days, the number of infections was 1 and 7 respectively, and the CRBSI infection rate was 0.48 and 3.32 persontimes per thousand catheter days respectively. The CRBSI infection rate in the observation group was lower than that in the control group(z = 2.10, P<0.05). Conclusions The use of checklists in the process of neonatal umbilical vein catheterization can help operators and post-maintenance staff to remain vigilant, eliminate potential safety hazards, prevent errors, continue to improve, ensure the safety of children, and effectively reduce the CRBSI infection rate.
Key words:  Neonate')" href="#">Neonate    Umbilical vein catheterization    Checklist    Catheter-related bloodstream infection
收稿日期:  2019-07-08                出版日期:  2020-01-30      发布日期:  2020-01-22      期的出版日期:  2020-01-30
基金资助: 河北省2016 年度医学科学研究重点课题项目(冀卫办科教〔2016〕4 号)
通讯作者:  李书芳    E-mail:  15831006236@163.com
引用本文:    
李书芳 张艳 李艳民 魏燕云 孙园园 郭志灵. 新生儿脐静脉置管核查表单在降低导管相关血流感染率中的作用[J]. 发育医学电子杂志, 2020, 8(1): 67-71.
LI Shu-fang, ZHANG Yan, LI Yan-min, et al. Effect of umbilical vein catheterization checklist on reducing catheter-related bloodstream infection rate in neonates. Journal of Developmental Medicine(Electronic Version), 2020, 8(1): 67-71.
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