【正文】
建議。(Grade B),第四十頁,共四十四頁。,如何預防中心靜脈導管(dǎoguǎn)相關血流感染,用于全胃腸外營養(yǎng)〔TPN〕輸注的裝置一般應為每24小時更換一次。如果溶液(r243。ngy232。)只包含葡萄糖和氨基酸,在連續(xù)使用時更換頻率不高于每72小時一次。(Grade B) 不推薦通過定期更換短期導管以降低感染率 。(Grade B) CVC插入24小時后需更換敷料,然后每周換一次,除非有特殊需更換的指征〔如有滲出〕。(Grade B) 假設非緊急情況應防止插入股靜脈。(Grade A) 常規(guī)使用生理鹽水沖洗CVC 。(Grade A),第四十一頁,共四十四頁。,參考文獻,1. National Institute for Clinical Excellence (NICE). Infection control: prevention of healthcareassociated infection in primary and community care: full guideline. NICE, 2003。 (2). 2. Hamilton HC, Foxcroft D. Central venous access sites for the prevention of venous thrombosis, stenosis and infection in patients requiring longterm intravenous therapy. Cochrane Database Sys Rev. 2007 (3). (Level I) 3. Ge X, Cavallazzi R, Li C, Pan SM, Wang YW, Wang FL. Central venous access sites for the prevention of venous thrombosis, stenosis and infection. Cochrane Database Syst Rev. 2022。 3. (Level I) 4. Bishop L, Dougherty L, Bodenham A, Mansi J, Crowe P, Kibbler C, Shannon M, Treleavan J. Guidelines on the insertion and management of central venous access devices in adults. Int J Lab Hematol. 2007。 29。 261–278. (Level IV) 5. Huang EY, Chen C, Abdullah F, Aspelund G, Barnhart DC, Calkins CM, Cowles RA, Downard CD, Goldin AB, Lee SL, St Peter SD, Arca MJ. Strategies for the prevention of central venous catheter infections: an American Pediatric Surgical Association Outcomes and Clinical Trials Committee systematic review. J Pediatr Surg. 2022。 46 (10):200011. (Level I),第四十二頁,共四十四頁。,Thank You!,第四十三頁,共四十四頁。,內容(n232。ir243。ng)總結,血管通道器材的評估與選擇。什么是血管通道器材 VADs。溶液處于等滲或接近(jiēj236。n)等滲狀態(tài)。血液動力學監(jiān)測〔中心靜脈壓監(jiān)測〕。CVC操作常由醫(yī)師操作。敷貼部位應每日評估,檢查置管部位的情況。假設手上有可見污物或被灰塵、有機物污染,在用酒精搓手前必須用肥皂和水清洗。更換敷料時需要用酒精溶液或葡萄糖酸氯己定清潔導管穿刺點,并保持枯燥 (Grade A)。Thank You,第四十四頁,共四十四頁