超声引导锁骨下静脉精确置管对危重患者导管相关性血流感染的影响  

Study on the influence of ultrasound-guided supraclavicular venous catheterization on catheter-related bloodstream infection in critically ill patients

作　　者：李美[1] 葛庆玲[1] 

机构地区：[1]莱芜市人民医院市中分院彩超室,山东莱芜271199

出　　处：《临床和实验医学杂志》2015年第24期2097-2099,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的探究超声引导锁骨下静脉精确置管对危重患者导管相关性血流感染的影响,以降低血流感染率。方法随机选取2013年1月至2014年1月收治的危重患者260例,分为对照组和试验组,每组130例。对照组采用经外周静脉穿刺中心静脉置管(PICC)进行深静脉插管,试验组采用超声引导锁骨下静脉置管法进行深静脉置管。比较两组患者置管情况平均穿刺所需时间、一次穿刺成功率、平均导管留置时间及患者置管后发生导管相关性血流感染的情况。结果两组患者穿刺所需时间和导管留置时间差异无统计学意义(P>0.05)。试验组的一次穿刺成功率为95.38%,高于对照组(86.15%)(P<0.05)。试验组导管相关性血流感染发生率为0.77%,低于对照组(6.15%),差异具有统计学意义(P<0.05)。结论超声引导锁骨下静脉精确置管能有效提高穿刺成功率,减少危重患者导管相关性血流感染的发生,对于危重患者的救治有着重要的临床意义。Objective To explore the influence of ultrasound- guided supraclavicular venous catheterization in reducing the incidence of catheter related bloodstream infection in critically ill patients. Methods A total of 260 critically ill patients during January 2013 to January 2014 treated in this hospital were divided into control and trial groups,each group with 130 cases. Deep venous catheterization was performed in patients of control group through peripherally inserted central venous catheter（ PICC）,and deep venous catheterization in patients of trial groupwas performed by using ultrasound- guided subclavicular vein catheterization. The average time required for catheterization,the successful rate of puncture,the average time for catheterization and the incidence of catheter- related bloodstream infection were compared between these 2 groups. Results The difference in time required for puncture and the duration for catheterrization in these 2 groups was not significant（ P 〉 0. 05）. The successful rate ofpuncture in trial group was 95. 38%,and it was higher than that（ 86. 15%） of control group（ P 〈 0. 05）. The incidence rate of catheter- related bloodstream infection in trial group was 0. 77%,it was lower than that of control group（ 6. 15%）,and the difference was statistically significant（ P 〈 0. 05）. Conclusion Supraclavicular intravenous catheterization under the guidance of ultrasound can raise the successful rate of precise puncture and reduce theincidence of catheter related bloodstream infection in critically ill patients,and it has important clinical significance in treatment of critically ill patients.

关 键 词：锁骨下静脉置管 超声引导 中心静脉置管 导管相关性血流感染 

分 类 号：R543.6[医药卫生—心血管疾病]