重症烧伤休克回吸收期深静脉置管留置时间的临床研究

Deep Venous Puncture Pathway in Severely Burned Patients During Their Shock Reabsorb Phase and 3 Days Thereafter: A Clinical Study on Duration of Cannulation

目的探讨深静脉穿刺置管在重症烧伤休克回吸收期的留置时间. 方法对我科2000年9月1日～2002年9月1日2年时间,重症烧伤休克回收期内的病例进行前瞻性研究;按深静脉置管后留置时间不同,分为7 d内置管入路更换组及7 d内置管入路不更换组,比较组间导管相关性细菌定植(CAC)、导管相关性软组织感染(CAI)、导管相关性菌血症(CAB)的发生率. 结果 CAC发生率在7 d内置管入路不更换组高,差异显著,CAI、CAB的发生率在组间无显著差异. 结论重症烧伤休克回吸收期,深静脉置管留置约7 d是安全的.

OBJECTIVE To explore the appropriate duration of cannulation by deep venous puncture pathway in severelyburned patients during their shock reabsorb phase and 3 days thereafter. METHODS This prospective study was conducted at our unit over two years, from Sept 1, 2000 to Sept 1, 2002. According to the demands of the design, given cannulated by deep venous puncture pathway, burned patients with 30% TBSA or more but withoutsevere inhalation injuries were recruited in the present study and, were randomized into two groups, one group was subjected to being cannulated with pathway-alteration within 7 days (alteration group), the other group without pathway-alteration within the similar period (non-alteration group), the incidence of CAC, CAI, and CAB was gained and compared. RESULTS A total of 121 qualified patients had finished the study, the alteration group had 71 cases, the non-alteration group 50 cases. The incidence of CAC in non-alteration group was significanthigher than that in alteration one, but the differences of the incidence of CAI and CAB between groups were insignificant. CONCLUSIONS The seven days duration of annulation by deep venous puncture pathwayin severely burned patients during their shock reabsorb phase and 3 days thereafter is safe.