Correlation Research Of The Effect With Different Catheter Disinfection Methods Applied On The Hemodialysis Patients

Object: To explore a scientific disinfection method for hemodialysispatients with central venous catheter，which is effective in preventing patiensfrom infection and extending the life of catheters。Methods: Choose a total of90patients who accepted treatment of internaljugular venipuncture in the first hospital of jilin university’s dialysis center, andcontinued dialysis a month from August2010to August2011,They were randomly divided into three groups, each group of30cases.Among them1case death,3cases taked off the tube,5cases discontinuedtreatment and left hospital.81cases were left in the final group,28cases ofgroup A, Group B26cases,27cases of group C. For nursing catheters groupA were cared according to the methods①; group B according to the method②; group C according to the method③.Three groups of patients were takenspecimens for bacterial culture in the catheter of exit site skin and catheterarteriovenous after1st day,10th day,20th day and30th day, at the same timeleave a blood specimen. And record the catheter site’s redness, bleeding,bacterial culture and white blood cell count in patients, then do the datastatistics analysis.Results:1.Comparison of three groups of patients ’ body temperatureIn this study,81cases in the course of dialysis had no temperature above38.5℃, also does not appear such as aversion to cold, shivering,so we candetermine catheter infection not occurred in these patients. Three groups ofpatients intubated had no purulent exudate at the exit, can be diagnosed withouttunnel infection. Temperature above37.5°c individual cases can be found in the first days, but no statistically significant among the three groups,(P>0.05).Consider the foreign body reaction after early puncture to increase bodytemperature. On the tenth day, the20th day, the30th day comparison oftemperature, temperature changed without rising trend, no statisticalsignificance between the three groups.In individual cases white blood countabove10x109/L, but in four times in comparison were no statisticalsignificance.2. Observation of three groups of patients with skin conditions1st day,10thday,20th day, made comparison of intubation site redness ingroups a, b, c, results were not significantly different (p﹥0.05).30th day oflocal skin irritation, A group42.86%,B group23.08%,C group14.81%,comparison between A and C group had a statistically significant difference(p﹤0.05). Bleeding in three groups of patients after intubation showed that in thetenth day67.56%in group A,38.46%in group B,,37.04%in Group C.Between A and B groups are different (P<0.05), A and C were statisticallysignificant (P<0.05)3.bacterial culture of three groups of patients3.1Catheter of bacterial culture results showed that the four time pointsin each group was statistically no difference.3.2In20th day Catheter exit (skin) culture-positive rate in group A culturepositive rate was25.00%,23.07%in Group B,3.7%in Group C. A and Bgroups were no statistical difference (P>0.05), while A and C groups (P<0.05), B and C groups were statistically significant (P<0.05).Culture-positive rate for the30th day,A group35.71%,B group34.61%,CGroup11.11%. A and B group had no statistical difference between the twogroups (p﹥0.05),while A and C groups (p﹤0.05),B and C groups (p﹤0.05),had a statistically significant.4. the comparison with three groups of patients at different time pointsCannulation site bleeding in group A patients at four time points weresignificantly different (P <0.0001); the skin bacterial culture results ofcatheter exit were statistically significant (P<0.05).Cannulation site bleeding in group B patients, at four time points weresignificantly different (P<0.05); the skin bacterial culture results of catheterexit were statistically significant (P<0.05).Cannulation site bleeding in group C patients, at four time points weresignificantly different (P<0.05).White blood cell count (﹥10x109/L) in three groups at each time point,is not statistically significant (P<0.05).5. Bacteria cultivation speciesThis experiment is to cultivate a of the communist party of China mainlyfor bacteria staphylococcus epidermidis, streptococcus, grass greenstaphylococcus aureus, etc, are all skin normal flora.Conclusion:(1) skin bacteria colonize at catheter exit (puncture point)easily.(2) Compared with improvement method1and traditional method,Improved method2for catheter terminal disinfects processing exit skin care aresuperior and more suitable for clinical application.