不同消毒剂对超声引导颈内静脉穿刺和敷贴粘合的影响  

Influence of different disinfectants on ultrasound-guided internal jugular vein puncture and adhesive application

作　　者：马金柱 高海燕 王浩 杨茗岚 胡春晖 汪东亮 MA Jin-zhu;GAO Hai-yan;WANG Hao;YANG Ming-lan;HU Chun-hui;WANG Dong-liang(Department of Emergency,Suqian Hospital of Jiangsu Provincial People's Hospital,Suqian Jiangsu 223800,China;Department of Urology,Suqian Hospital of Jiangsu Provincial People's Hospital,Suqian Jiangsu 223800,China)

机构地区：[1]江苏省人民医院宿迁医院急诊科,江苏宿迁223800 [2]江苏省人民医院宿迁医院泌尿外科,江苏宿迁223800

出　　处：《局解手术学杂志》2025年第2期147-150,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：江苏省宿迁市科技项目(K201919)。

摘　　要：目的 明确不同消毒剂对超声引导颈内静脉穿刺情况和敷贴粘合的影响。方法 选择行超声引导颈内静脉穿刺置管的急诊外伤失血患者102例为研究对象,随机分为碘伏组(51例)和氯己定醇组(51例),分别于穿刺前使用0.5%有效碘的碘伏和2.0%葡萄糖酸氯己定+70.0%乙醇消毒。比较2组患者穿刺部位消毒效果、穿刺情况、超声成像情况和敷贴粘合力。结果 2组患者穿刺部位消毒前菌群计数、消毒后菌群计数及消毒合格率比较,差异均无统计学意义(P>0.05)。2组一次穿刺成功率、穿刺次数和穿刺置管时间比较,差异均有统计学意义(P<0.05)。2组超声成像清楚率、敷贴粘合力和穿刺后24 h敷贴起翘或脱落率比较,差异均有统计学意义(P<0.05)。结论 对于急诊外伤失血患者,在超声引导颈内静脉穿刺前使用0.5%有效碘的碘伏和2.0%葡萄糖酸氯己定+70.0%乙醇消毒,均可获得较好的消毒效果,其中碘伏消毒能获得更清楚的超声成像,且一次穿刺成功率更高,但敷贴粘合力较差,容易发生起翘或脱落。Objective To investigate the influence of different disinfectants on the ultrasound-guided internal jugular vein puncture and adhesive application.Methods A total of 102 emergency patients with traumatic hemorrhage who underwent ultrasound-guided internal jugular vein puncture and catheterization were selected as the study subjects and randomly divided into the iodine group(51 cases)and the chlorhexidine-alcohol group(51 cases).Iodophor(0.5%effective iodine)and 2.0%chlorhexidine gluconate+70.0%ethanol were used for disinfection before puncture,respectively.The disinfection effect of the puncture site,puncture condition,ultrasound imaging,and adhesive force of the application of patients were statistically compared between the two groups.Results There was no significant difference in the bacterial count before disinfection,the bacterial count after disinfection or the qualified rate of disinfection at the puncture site of patients between the two groups(P>0.05).There were significant differences in the success rate of one-time puncture,the number of puncture and the time of puncture and catheterization between the two groups(P<0.05).There were significant differences in the rate of clear ultrasound images,adhesive force and rate of warping or shedding of the application between the two groups(P<0.05).Conclusion For emergency patients with traumatic hemorrhage,using iodophor(0.5%effective iodine)and 2.0%chlorhexidine gluconate+70.0%ethanol disinfection before ultrasound-guided internal jugular vein puncture can achieve good disinfection effects.Iodine disinfection can obtain clearer ultrasound images and a higher success rate of one-time puncture,but the adhesive force of the application is poor,making it prone to warping or shedding.

关 键 词：消毒方法 超声引导 颈内静脉穿刺 一次穿刺成功率 敷贴 粘合力 

分 类 号：R197.3[医药卫生—卫生事业管理]