锁骨下静脉导管改良固定方法的应用观察

目的探讨两种不同的深静脉导管固定方法对深静脉置管相关性感染的影响。方法选择广东省佛山市顺德区中医院ICU收治的140例行锁骨下静脉置管患者为研究对象,将所有患者随机分为观察组(n=70)和对照组(n=70),观察组采用改良导管固定方法,不使用蝶形夹,单纯缝线固定,而对照组采用传统固定方法,使用蝶形夹皮肤缝合固定,2组置管方式及后期维护相同。分别记录2组导管留置时间、脱管例数及导管相关感染例数。结果观察组导管留置时间为(27.5±11.7)d,对照组导管留置时间为(17.5±12.1)d,观察组导管留置时间明显长于对照组,2组比较,差异有统计学意义;2组脱管例数分别为5例、3例,脱管率比较,差异无统计学意义;观察组和对照组的导管相关性感染例数分别为6例、11例,2组的导管日感染率分别为3.1‰、8.98‰,观察组的导管相关日感染率明显低于对照组,2组比较,差异有统计学意义。结论不使用蝶形夹的改良导管固定方法较传统方法可明显延长留管时间,并降低导管相关感染的发生率,且并不增加脱管率,值得推广应用。

Objective To explore the affection of the two different fixation methods of deep venous catheter on deep venous catheter-relation infections. Methods We observed 140 cases on subclavian vein intubations of ICU in our hospital. All the cases were divided into the observation group and the control group with 70 cases in each group, The observation group was treated with modified catheter fixing method, we didn’t use the butterfly clip, and we used simple suture fixation;While the control group was used the traditional fixing method and the butterfly clip skin suture, but the catheter and maintenance is the same as the two groups. We recorded and catheter indwelling time, the number of tube and catheter related infection cases. Results There was a significant difference, the improved method group was longer than that of the traditional method of indwelling time group;the improved methods of fixation group catheter indwelling time was （27.5 ±11.7） days, but the traditional method of fixed group of catheter indwelling time was （17.5 ± 12.1） days, The decannulation rate showed no significant difference, the two group of tube off the number of cases were 5 cases, 3 cases;there was a significant difference between the days of the observation group, the catheter related infection rate was significantly lower than the control group. The catheter related the observation group and the control group of infection cases were 6 cases, 11 cases, the two groups of catheter day’s infection rate was 3.1‰, 8.98‰. Conclusion We didn’t use the improved catheter fixation methods butterfly clip is superior to the traditional methods. Because It can be obviously prolong the indwelling time, and it can reduce the incidence of catheter related infection, and It isn’t also increase the decannulation rate. So we deem it is worth promoting the application.