超声定位下深静脉置管在减少导管相关性感染中的作用

Utility of ultrasound locations in reducing catheter-related infection in patients undergoing central venous catheterization

目的评价床边超声定位下进行深静脉置管在减少导管相关性感染中的作用。方法采用前瞻性、随机对照分析方法,对2010年6月—2012年9月在绍兴市人民医院综合性ICU收治的110例需要深静脉置管患者进行随机分组,分别在超声定位下进行深静脉留置(超声组,n=58)和传统体位标志定位下进行深静脉留置(对照组,n=52),比较2组的导管置管时间、一次置管成功率、导管留置天数及相应的感染指标。采用SPSS 16.0软件包进行统计分析,组间均数比较用t检验,组间比较采用χ2检验。结果超声组置管天数(14.2±4.5)d,对照组为(7.8±5.8)d,比较差异有统计学意义(P<0.05);超声组导管细菌定植率为8.62%,明显低于对照组的25.0%(P<0.05)。结论超声定位下进行深静脉置管能够显著降低局部导管相关感染和导管细菌定植,能延长导管的留置时间,增加置管的安全性。

Objective To evaluate the effect of ultrasound locations in reducing catheter-related infection in the central venous catheterization. Methods The analysis of a prospective randomized trial was carried out in 110 patients in our general ICU from June of 2010 to September of 2012. They were randomized to ultrasound-guided group （n = 58 ） and landmark method group（n = 52） according to whether or not use ultrasound locations in central venous catheterization. The operation time, right-first-time success rate of intubation, days of indwelling catheter, and indicators of bacterial infec- tion was compared between the two groups. The statistical analysis （t-test and Chi square test） was carried out by SPSS 16.0 software. Results The mean days of indwelling catheter in ultrasound-guided group was （ 14.2 ＋ 4.5 ） d and （7.8 ＋ 5.8 ） d in landmark method group, the difference was statistically significant（ P 〈 0.05 ）. The incidence of bacterial coloni- zation of catheter in the ultrasound guided group was significantly lower than that in control group （8.62% vs 25.0%, P 〈 0.05）. Conclusion The uhrasound-guided catheterization can be beneficial in reducing bacterial colonization and catheter-related infection in the central venous catheterization.