心脏瓣膜替换术后不同处理措施对中心静脉置管感染与IL-6和TNF-ɑ及应激因子的影响

发布时间：2019-08-01 17:46

【摘要】：目的探讨心脏瓣膜替换术后不同处理措施对中心静脉置管感染及IL-6、TNF-ɑ、应激因子的影响,为降低中心静脉置管后感染提供数据依据。方法选择2014年3月-2016年1月医院收治心脏瓣膜替换术患者208例,按入院顺序将其分为观察组与常规组,常规组100例给予穿刺部位处理,观察组108例给予综合处理,观察两组患者置管时间、置管期间相关感染发生情况;置管前后不同时间炎性因子及应激因子水平情况;置管期间其它并发症发生情况。结果观察组总感染及全身感染率低于常规组(P0.05),两组患者置管前应激、炎性因子对比,差异均无统计学意义。观察组置管后不同时间应激因子丙二醛(MDA)水平低于同组置管前及常规组同期(P0.05),超氧化物歧化酶(SOD)水平低于同组置管前(P0.05),高于常规组同期(P0.05),置管后不同时间肿瘤坏死因子(TNF-ɑ)、白细胞介素-6(IL-6)水平均高于置管前(P0.05),低于对照组同期(P0.05),其它并发症发生率对比差异无统计学意义。结论心脏瓣膜替换术给予综合处理措施对中心静脉置管相关感染具有预防作用,可降低炎性因子、氧化应激因子水平,值得临床推广。
[Abstract]:Objective to investigate the effect of different management measures on central venous catheterization infection, IL-6,TNF- stress factor and stress factor after cardiac valve replacement, and to provide data basis for reducing central venous catheterization infection. Methods 208 patients undergoing cardiac valve replacement from March 2014 to January 2016 were divided into observation group and routine group according to the order of admission. 100 patients in routine group were treated with puncture site, 108 patients in observation group were given comprehensive treatment, the time of catheterization, the incidence of related infection during catheterization, the levels of inflammatory factors and stress factors at different time before and after catheterization, and other complications during catheterization were observed. Results the total infection and systemic infection rate in the observation group were lower than those in the routine group (P 0.05). There was no significant difference in stress and inflammatory factors between the two groups before catheterization. In the observation group, the level of malondialdehyde (MDA) (MDA) was lower than that before catheterization and the same period in routine group at different time after catheterization (P 0.05), and the level of SOD (SOD) was lower than that before catheterization (P 0.05), which was higher than that before catheterization (P 0.05). The levels of tumor necrosis factor (TNF-) and IL 6 (IL-6) at different time after catheterization were higher than those before catheterization (P 0.05). Compared with the control group (P 0.05), there was no significant difference in the incidence of other complications. Conclusion the comprehensive treatment of cardiac valve replacement has preventive effect on central venous catheterization related infection, and can reduce the level of inflammatory factors and oxidative stress factors, which is worthy of clinical promotion.
【作者单位】：河南省人民医院(郑州大学人民医院)心外科;
【基金】：2015年度河南省医学科技攻关计划项目(201503H010)
【分类号】：R654.2

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