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Objective:To compare the effect of the 2% chlorhexidinegluconate disinfectant and 0.5% iodophor disinfectant on the maintenance of central venous catheter (CVC) in patients with immunodeficiency.Methods:The patients were randomly divided into two groups. 2% chlorhexidinegluconate disinfectant was used in the experimental group, and 0.5% iodophor disinfectant was used in the control group. The CVC was sterilized once a week and continuously maintained for 3 weeks. According to the condition of catheter, the dressing was changed in time in case of any problem,and the reason and time for the catheter nursing care were recorded. The duration of changing the catheter dressing in different disinfectant, incidence rate of dressings looseness and incidence of catheter-related infections in two groups were analyzed.Results:The duration of skin drying and duration of caring in the experimental group were (0.62±0.10)min, (11.67±0.33) min, significantly shorter than the control group [(1.97±0.18) min, (14.48±0.33) min]( t values were 63.044, 57.296, P<0.01).In term of the adverse effects on CVC,there were no statistical differences between two groups ( P> 0.05). Conclusions:Both 2% chlorhexidinegluconate and 0.5% iodophor disinfectant have similar disinfection effect on CVC caring, but 2% chlorhexidinegluconate disinfection is more efficient and worthy of application in clinical settings.
RESUMO
The nursing experience of one hemaphagocytic syndrome patient with skin damage complication who underwent haploidentical hematopoietic stem cell transplantation were summarized. The patients gradually appeared ulceration of elbow joint skin, perianal mucosa, and bilateral axillary skin during the phase of agranulocytopenia and immune inhibition after transplantation. The overall skin ulceration area was accounted for 13% of total body surface area. We chose different dressings, combination anti-infection with promoting wound healing for nursing and achieved great effect. The skin lesions gradually healed and the patient went to the general ward successfully.
RESUMO
Objective To investigate the comprehensive prevention strategy in the prevention of oral mucositis (OM) during allogeneic hematopoietic stem cell transplantation (HSCT). Methods A total of 721 patients who received HSCT from January 2010 to December 2011 at the Institute of Hematology, Peking University were enrolled. All the patients received the comprehensive prevention strategy of OM. Results A total of 315 patients (43.7 percents) suffered from OM during HSCT, the median time from HSCT to OM occurrence was 5 days. There were 173 (54.9 percents), 91(28.9 percents), 37(11.7 percents), and 14(4.4 percents) patients suffered from gradeⅠ,Ⅱ,Ⅲ, and IV OM, respectively. Tongue OM was most common. A total of 111 patients suffered from multiple OM (≥2 locations). Multiplicity showed that duration of agranulocytosis≥15 days was the only independent risk factor of OM in HSCT [ hazard ratio (HR) value 1.5, P<0.05 ]. Neutrophil engraftment time≥12 days was significantly associated with prolonged OM (≥8 days) (HR=2.1, P<0.05). Patient age ≥20 was independent risk factor for occurrance of grade Ⅲ-Ⅳ OM (HR=2.7, P<0.05). Conclusions Comprehensive prevention strategy can overcome the risk factors of OM and prevent the occurrence of OM during HSCT.
