腋静脉穿刺可降低中心静脉导管相关血流感染的发生率

叶志辉, Ye Zhihui, 丁洪光, Ding Hong-guang, 叶靖坤, Ye Jingkun, 蔡耿鑫, Cai Gengxin, 曾红科, Zeng Hong-ke, 温妙云, Wen Miaoyun
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引用次数: 0

摘要

目的比较不同干预措施对中央线相关性血流感染(CLABSI)发生率的影响。方法回顾性分析218例中心静脉置管患者的临床资料。感染患者作为CLABSI组,未感染患者作为对照组。结果218例患者中,24例发生CLABSI。CLABSI组与对照组在性别、年龄、原发感染情况、穿刺部位等方面均无显著差异。单因素分析显示,腋窝静脉穿刺可显著降低CLABSI发生率(P=0.028), b超下每1000天腋窝静脉穿刺感染率显著降低0.93‰。脉搏穿刺组深静脉置管平均留置时间明显长于其他组(47.32天vs 19.90天)。B超定位腋窝静脉穿刺组平均留置时间较其他部位静脉穿刺组长(P < 0.05)。Logistic多元回归分析显示,解剖定位穿刺(P = 0.031)和非腋窝静脉置管(P = 0.068)是CLABSI的主要危险因素。结论选择腋静脉为深静脉置管位置,超声引导下中心静脉穿刺可降低CLABSI发生率,延长平均置管时间。关键词:腋窝静脉;超声引导;中心静脉相关血流感染;病例对照研究
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The axillary vein puncture can reduce the incidence of central venous catheter-related bloodstream infection
Objective To compare the effects of various interventions on the incidence of central line-associated bloodstream infection (CLABSI) . Methods The clinical data of 218 patients with central venous catheterization were retrospectively analyzed. Infected patients were treated as CLABSI group and non-infected patients as control group. Results Of the 218 patients, 24 patients were developed CLABSI. There was no significant difference in sex, age, primary infection status and puncture site between CLABSI group and control group. Univariate analysis showed that axillary vein puncture could significantly reduce the incidence of CLABSI (P=0.028), and the infection rate of axillary vein puncture per 1000 days under B-ultrasound was significantly reduced by 0.93‰. The average indwelling days of deep venous catheter in patients with pulse puncture were significantly longer than those in other groups (47.32 days vs 19.90 days). The average indwelling days in patients with axillary vein puncture positioned by B ultrasound were longer than those in patients with other parts of vein puncture positioned by B ultrasound (P < 0.05). Logistic multiple regression analysis showed that the main risk factors for CLABSI were anatomically located puncture (P = 0.031) and non-axillary venous catheterization (P = 0.068). Conclusions Choosing axillary vein as the position of deep venous catheterization and using ultrasound-guided central venous puncture can reduce the incidence of CLABSI and prolong the average catheterization time. Key words: Axillary vein; Ultrasound-guided; Central line-associated bloodstream infection; Case control study
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中华急诊医学杂志
中华急诊医学杂志 Nursing-Emergency Nursing
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期刊介绍: Chinese Journal of Emergency Medicine is the only national journal which represents the development of emergency medicine in China. The journal is supervised by China Association of Science and Technology, sponsored by Chinese Medical Association, and co-sponsored by Zhejiang University. The journal publishes original research articles dealing with all aspects of clinical practice and research in emergency medicine. The columns include Pre-Hospital Rescue, Emergency Care, Trauma, Resuscitation, Poisoning, Disaster Medicine, Continuing Education, etc. It has a wide coverage in China, and builds up communication with Hong Kong, Macao, Taiwan and international emergency medicine circles.
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