肿瘤化疗患者中线导管置管消毒措施及其应用效果

Measures for disinfection of central-line indwelling catheters of cancer patients undergoing chemotherapy and their application effects

    摘要
  • 摘要: 目的 比较苯扎氯铵溶液与0.5%碘伏+75%乙醇用于肿瘤化疗患者中线导管置管皮肤消毒的效果，分析其对中线导管置管感染及皮肤过敏的预防效果与临床安全性。方法 纳入2024年10月-2025年6月在中国人民解放军总医院第一医学中心肿瘤内科接受中线导管置管的160例肿瘤化疗患者,采用随机数字表法将其平均分配至试验组(n=80，使用0.10%苯扎氯铵溶液)和对照组(n=80，使用0.5%碘伏+75%乙醇)。比较两组患者穿刺点消毒前后菌落计数、消毒合格率、消毒耗时、置管24 h无菌透明敷贴起翘或脱落率、皮肤过敏反应发生率及导管相关血流感染(CRBSI)发生率。结果 两组消毒前菌落计数、消毒后菌落计数、消毒合格率及CRBSI发生率比较，差异均无统计学意义。试验组消毒耗时为(3.20±0.80)min，短于对照组的(5.80±1.20)min(t=16.125，P<0.001)；试验组置管24 h敷贴起翘或脱落率为8.75%(7/80)，低于对照组的28.75%(23/80)(χ2=10.502，P=0.002)；试验组皮肤过敏反应发生率为2.50%(2/80)，低于对照组的13.75%(11/80)(χ2=6.781，P=0.009)。结论 0.10%苯扎氯铵溶液用于肿瘤化疗患者中线导管置管的皮肤消毒，可降低皮肤过敏风险，减少敷贴脱落，缩短消毒时间，且在预防导管血流感染方面与0.5%碘伏+75%乙醇效果相当，安全性更优。

     

    Abstract: OBJECTIVE To compare the efficacy of benzalkonium chloride solution and 0.5% iodophor + 75% alcohol in skin disinfection for midline catheter placement in patients undergoing cancer chemotherapy, and to analyze their preventive effects and clinical safety against catheter-related infections and allergic skin reactions. METHODS A total of 160 patients with cancer undergoing chemotherapy who received midline catheter placement at the oncology department of The First Medical Center, Chinese PLA General Hospital from Oct. 2024 to Jun. 2025 were included. They were randomly assigned to a intervention group (n=80, receiving 0.10% benzalkonium chloride solution) and a control group (n=80, receiving 0.5% iodophor + 75% alcohol) through a random number table method. The colony counts before and after disinfection at the puncture site, disinfection pass rate, disinfection time, rate of lifting or detachment of sterile transparent dressings 24 hours after catheter placement, incidence of skin allergic reactions and incidence of catheter-related bloodstream infections (CRBSI) were compared between the two groups.RESULTS No statistically significant differences were observed in colony counts before and after disinfection, disinfection pass rate and incidence of CRBSI between the two groups. The disinfection time in the intervention group (3.20±0.80 minutes) was shorter than that in the control group (5.80±1.20 minutes) (t=16.125, P<0.001). The rate of lifting or detachment of dressings 24 hours after catheter placement in the intervention group was 8.75% (7/80), lower than that in the control group (23/80, 28.75%) (χ2=10.502, P=0.002). The incidence of skin allergic reactions in the intervention group was 2.50% (2/80), lower than that in the control group (11/80, 13.75%) (χ2=6.781, P=0.009). CONCLUSIONS The use of 0.10% benzalkonium chloride solution for skin disinfection in midline catheter placement in patients with cancer undergoing chemotherapy can reduce the risk of skin allergies, decrease dressing detachment and shorten disinfection time. It is equally effective as 0.5% iodophor + 75% alcohol in preventing CRBSI and offers superior safety.

     

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