循证护理结合葡萄糖酸氯己定抗菌敷料预防腹膜透析导管相关感染

IF 0.7 4区 材料科学 Q3 Materials Science Materials Express Pub Date : 2024-03-01 DOI:10.1166/mex.2024.2601
Zuping Wang, Zhang Lin, Fayiza Aikelamu, Gulixian Tuerhong
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引用次数: 0

摘要

为有效预防腹膜透析(PD)期间导管相关感染,我们将循证护理(EBC)和葡萄糖酸氯己定抗菌敷料(CHGAD)应用于腹膜透析患者的管理中。CHGAD 具有良好的吸湿性,可有效防止血液和渗出物在导管出口处聚集。此外,CHGAD 还能有效抑制 G+ 和 G- 细菌的活性,为伤口提供有效的抗菌效果。此外,我们还发现 CHGAD 还具有良好的生物相容性,不会影响成纤维细胞的活性。接受腹膜透析治疗的患者被随机分配到对照组或 EBC 组。对照组接受标准治疗,而 EBC 组在接受 EBC 治疗的同时也接受 CHGAD 治疗。随后,我们比较了两组患者与医疗相关的风险因素、治疗依从性、自我护理、导管感染率和满意度。结果表明,EBC 通过改善患者的 Hb、HbA1c 和 Alb 水平依从性,以及手卫生依从性、透析用水管理、高频接触台、消毒隔离和透析期间的导管维护,有效降低了导管感染的风险因素。此外,EBC 还提高了患者的治疗依从性、自我护理能力和对透析导管管理的参与度。EBC 和 CHGAD 的联合应用有效降低了导管感染的发生率,并提高了患者对护理的满意度。因此,EBC与CHGAD联合治疗在管理腹膜透析患者导管感染方面显示出巨大潜力,应在临床实践中加以推广。
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Evidence-based care combined with chlorhexidine gluconate antimicrobial dressing in the prevention of peritoneal dialysis catheter-associated infections
To effectively prevent catheter-related infections during peritoneal dialysis (PD), we have applied evidence-based care (EBC) and chlorhexidine gluconate antimicrobial dressings (CHGAD) to the management of PD patients. CHGAD demonstrated good hygroscopic properties, effectively preventing the pooling of blood and exudate at the catheter outlet. Additionally, CHGAD could effectively inhibit the activity of G+ and G− bacteria, providing effective antibacterial effect on the wound. Furthermore, we found that CHGAD also exhibited good biocompatibility without affecting the activity of fibroblasts. Patients undergoing PD treatment were randomly assigned to either the control or EBC group. The control group received standard care while the EBC group received EBC along with CHGAD. Subsequently, we compared patient- and healthcare-related risk factors, treatment adherence, self-care, catheter infection rates, and satisfaction between the two groups. The results demonstrated that EBC effectively reduced risk factors for catheter infections by improving compliance rate of patients’ Hb, HbA1c, and Alb level, as well as hand hygiene compliance, dialysis water management, high-frequency contact table, disinfection and isolation, and catheter maintenance during dialysis. Furthermore, EBC improved patients’ treatment adherence, self-care ability, and participation in PD catheter management. The combination of EBC and CHGAD effectively reduced the incidence of catheter infections and improved patient satisfaction with care. Consequently, EBC combined with CHGAD shows significant potential in the management of catheter infections in PD patients and should be advocated in clinical practice.
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Materials Express
Materials Express NANOSCIENCE & NANOTECHNOLOGY-MATERIALS SCIENCE, MULTIDISCIPLINARY
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