生理盐水在头孢类抗生素过敏试验前皮肤擦拭中的应用效果
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摘要
目的探讨生理盐水在头孢类抗生素过敏试验前皮肤擦拭中的应用效果。方法选取2016年9月～2017年3月四川省骨科医院下肢科收治且行头孢类抗生素过敏试验的500例患者,采用随机数字表法将其分为实验组和对照组,每组250例。实验组头孢类抗生素过敏试验前使用生理盐水进行清洁;对照组直接使用75%的酒精进行消毒。比较两组患者的头孢类抗生素过敏试效果及细菌学检测结果。结果实验组假阳性率明显低于对照组,差异有统计学意义(P <0.05)。两组患者均无细菌检测不合格者,无菌合格率均为100.00%。结论生理盐水用于头孢类抗生素过敏试验的皮肤清洁,能有效降低头孢类抗生素过敏试验假阳性发生率。
Objective To investigate the effect of normal saline on skin wiping before cephalosporin antibiotic allergy test. Methods A total of 500 patients who underwent cephalosporin antibiotic allergy test in the Department of Lower Extremities of Sichuan Provincial Orthopaedic Hospital from September 2016 to March 2017 were randomly divided into experimental group and control group, with 250 cases in each group. The experimental group was cleaned with physiological saline before the cephalosporin antibiotic allergy test; the control group was directly disinfected with 75% alcohol. The cephalosporin antibiotic allergy test results and bacteriological test results of the two groups of patients were compared. Results The false positive rate of the experimental group was significantly lower than that of the control group, and the difference was statistically significant(P < 0.05). There were no bacterial test failures in both groups, and the sterility pass rate was 100.00%. Conclusion The use of saline for skin cleansing in cephalosporin antibiotic allergy tests can effectively reduce the incidence of false positives in cephalosporin allergy tests.
Objective To investigate the effect of normal saline on skin wiping before cephalosporin antibiotic allergy test. Methods A total of 500 patients who underwent cephalosporin antibiotic allergy test in the Department of Lower Extremities of Sichuan Provincial Orthopaedic Hospital from September 2016 to March 2017 were randomly divided into experimental group and control group, with 250 cases in each group. The experimental group was cleaned with physiological saline before the cephalosporin antibiotic allergy test; the control group was directly disinfected with 75% alcohol. The cephalosporin antibiotic allergy test results and bacteriological test results of the two groups of patients were compared. Results The false positive rate of the experimental group was significantly lower than that of the control group, and the difference was statistically significant(P < 0.05). There were no bacterial test failures in both groups, and the sterility pass rate was 100.00%. Conclusion The use of saline for skin cleansing in cephalosporin antibiotic allergy tests can effectively reduce the incidence of false positives in cephalosporin allergy tests.
引文
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[2]刘小华.80例皮肤过敏试验假阳性的原因分析及护理对策[J].医学信息,2015,28(46):381-382.DOI:10.3969/j.issn.1006-1959.2015.46.576.
[3]李小寒,尚少梅.基础护理学[M].北京:人民卫生出版社,2006:225.
[4]中华人民共和国卫生部.WS/T 367-2012.医疗机构消毒技术规范[S].北京:中国标准出版社,2012.
[5]张晓敏.儿童青霉素皮内过敏试验假阳性原因分析及预防对策[J].海峡药学,2012,24(2):110-111.DOI:10.3969/j.issn.1006-3765.2012.02.053.
[6]金海英,沈爱国,叶宗敏,等.20806例头孢类药物皮试影响因素的logistic回归分析[J].中国医院药学杂志,2017,37(3):278-282.DOI:10.13286/j.cnki.chinhosppharmacyj.2017.03.17.
[7]李平,卜书红,周佳,等.β-内酰胺类抗菌药物临床交叉过敏反应的发生机制及美国相关处理流程介绍[J].中国药房,2017,28(26):3711-3715.DOI:10.6039/j.issn.1001-0408.2017.26.32.
[8]马小军.从皮试误区浅谈头孢菌素类抗生素的规范化应用[J].中华内科杂志,2014,53(6):433-434.DOI:10.3760/cma.j.issn.0578-1426.2014.06.005.
[9]周华,李光辉,陈佰义,等.中国产超广谱β-内酰胺酶肠杆菌科细菌感染应对策略专家共识[J].中华医学杂志,2014,94(24):1847-1856.DOI:10.3760/cma.j.issn.0376-2491.2014.24.003.
[10]陈敏,黄敏,邓兰兰,等.某市青霉素及头孢类抗菌药物皮肤过敏试验现状调查研究[J].中国药业,2016,25(5):4-6.
[11]李娟,何宁,杨莹莹,等.头孢菌素类药物皮试临床应用的研究进展[J].护理研究,2017,31(29):3629-3632.DOI:10.3969/j.issn.1009-6493.2017.29.002.
[12]董菊,刘玉,郭静,等.不同消毒剂对儿童抗菌药物皮试结果的影响[J].中国药房,2015,(23):3285-3286,3287.DOI:10.6039/j.issn.1001-0408.2015.23.41.
[13]温亚,郭锦丽,刘晋,等.皮试标尺的研制与应用[J].护理研究,2016,30(13):1662-1663.DOI:10.3969/j.issn.1009-6493.2016.13.042.
[14]黄玉凤,刘义秀.延时10 min观察对定向药透仪皮试结果准确性的影响[J].中国当代医药,2017,24(23):158-160.DOI:10.3969/j.issn.1674-4721.2017.23.050.
[15]周法庭,朱晓丹,波顺庆,等.β-内酰胺环和侧链结构诱导青霉素类抗生素过敏的研究进展[J].医学综述,2018,24(3):444-448.DOI:10.3969/j.issn.1006-2084.2018.03.006.
[16]许锦英,盛雪鹤,刘孟雪,等.皖南地区18所公立医院β-内酰胺类抗菌药物皮肤过敏试验现状分析[J].安徽医药,2017,21(5):943-947.DOI:10.3969/j.issn.1009-6469.2017.05.047.
[17] Jerschow E,Lin RY,Scaperotti MM,et al. Fatal anaphy-laxis in the United States,1999-2010:temporal patternsand demographic associations[J]. Allergy Clin Immunol,2014,134(6):1318-1328.
[18]刘伟斌.药物致皮肤过敏反应及处理探讨[J].临床合理用药杂志,2016,9(6):121-122.DOI:10.15887/j.cnki.13-1389/r.2016.06.066.
[19]袁颖,耿力.生理盐水代替乙醇皮试消毒液效果的系统评价[J].护理研究,2017,31(13):1595-1598.DOI:10.3969/j.issn.1009-6493.2017.13.016.
[20]李夏西,李星,鲁玫,等.生理盐水清洁与乙醇消毒用于青霉素皮试效果的Meta分析[J].中国实用护理杂志,2014,30(29):43-45.DOI:10.3760/cma.j.issn.1672-7088.2014.29.014.