【摘要】 目的 研究10mg/ml头孢唑啉-30%枸橼酸钠封管对维持性血液透析长期留置导管患者导管相关菌血症、导管功能不良发生率的影响。方法 选择我院使用长期留置导管的维持性血液透析患者25例，采取随机分组对照研究，试验组13例，采用10mg/ml头孢唑啉-30%枸橼酸钠封管，每周3次；对照组12例，全部使用肝素封管，每周3次，治疗6月，观察两组患者导管相关菌血症、导管功能不良的发生率及不良反应。结果 试验组患者导管相关菌血症发生2例次，发生率0.85/1000导管日，导管功能不良发生11例次，发生率1.17%；对照组患者导管相关菌血症发生5例次，发生率2.29/1000导管日，导管功能不良发生25例次，发生率2.87%；试验组导管相关菌血症及导管功能不良发生率显著低于对照组（p＜0.01）。两组患者观察前及6个月后血清Ca2+、Mg2+、ALT、AST比较无统计学差异（p＞0.05）。试验组不良反应发生率4.2‰，症状轻，可自行缓解。结论 与标准肝素封管相比较，10mg/ml头孢唑啉-30%枸橼酸钠封管能有效降低导管相关菌血症及导管功能不良的发生率，安全性良好。

[Abstract]:OBJECTIVE To determine whether 1% Cefazolin-30% sodium citrate prevents the catheter-related bacteremia and influences the incidence of the dysfunction of catheter.METHODS A randomized prospective controlled study was undertaken.25 hemodialysis patients were randomly divided into two groups,13 of group patients receive 1% Cefazolin-30% sodium citrate into each lumen of the catheter three times a week,12 of control group patients receive heparin locks only three times a week for 6 months.The incidence rates of the catheter-related bacteremia,the catheter dysfunction,and other adverse reactions were recorded. RESULTS The incidence of catheter-related bacteremia was 0.85/1000 catheter days in the group and 2.29/1000 catheter days in the control group, The incidence of catheter dysfunction was 1.17% in the group and 2.87% in the control group, The incidence of catheter-related bacteremia and catheter dysfunction between the two groups was statistically significant(p＜0.01）.The serum Ca2+、Mg2+、ALT、AST between the two groups showed no obvious changes before and after treatment(p＞0.05）.The main side effect in the group was 4.2‰,the symptom was spontaneous remission.CONCLUSION As compare with the heparin catheter locks, 1% Cefazolin-30% sodium citrate can effectively reduce the catheter-related bacteremia and catheter dysfunction,and it was safer.