75%乙醇封管治疗血液透析用隧道式中心静脉导管血流感染的临床效果

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Abstract Objective To investigate the clinical effect of 75%Ethanol catheter locks in the treatment of tunneled hemodialysis catheter-related blood stream infection.Methods A total of 62 cases of maintenance hemodialysis patients with central venous catheter-related blood stream infections from August 2016 to March 2018 in Affiliated Hospital of Weifang Medical University were selected as the research objects，according to different sealing methods，they were divided into the control group （18 cases），the Cefuroxime group （22 cases）and the Ethanol group （22 cases）.The control group was sealed with 50 mg/ml Heparin alone.The Cefuroxime group was sealed with Heparin （50 mg/ml）and Cefuroxime （20 mg/ml），while the Ethanol group was sealed with 75%Ethanol.The changes of body temperature，C-reactive protein （hs-CRP），white blood cell count （WBC），neutrophil count （NEU），neutrophil percentage （NEU%）and catheter dysfunction before and after catheter closure were detected.The clinical efficiency and the incidence rate of catheter dysfunction were compared among the three groups.Results The total clinical effective rate of the Ethanol group （95.5%）was higher than that of the Cefuroxime group （81.8%），the difference was statistically significant （P＜0.05）.The total clinical effective rate of the Ethanol group （95.5%）was higher than that of the control group （72.2%），the difference was statistically significant（P＜0.05）.The total effective rate of the Cefuroxime group （81.8%）was higher than that of the control group （72.2%），the difference was statistically significant （P＜0.05）.The total incidence rate of catheter dysfunction in the Ethanol group （12.1%）was lower than that in the Cefuroxime group （27.3%），the difference was statistically significant （P＜0.05）.There was no significant difference in the total incidence rate of catheter dysfunction between the Ethanol group （12.1%）and the control group （13.0%）（P＞0.05）.The total incidence rate of catheter dysfunction in the Cefuroxime group （27.3%）was higher than that in the control group （13.0%），the difference was statistically significant （P＜0.05）.Conclusion 75%Ethanol sealing and Cefuroxime sealing have good effect in the treatment of catheter blood stream infection，the effect of 75%Ethanol sealing is better than that of Cefuroxime sealing，and the incidence rate of catheter dysfunction is low.

Key words： Tunneled central venous catheter Catheter-related blood stream infection Maintenance hemodialysis 75%Ethanol Cefuroxime

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