超声引导下中心静脉置管失败的相关因素logistic回归分析

Logistic Regression Analysis of Factors Associated with the Failure of Central Venous Catheterization Under Ultrasound Guidance

目的:探讨超声引导下中心静脉置管失败的相关因素并进行logistic回归分析,以求降低其失败率。方法:回顾性分析2014年1月至2016年12月在超声引导下置入中心静脉导管的322例患者,分析导致置管失败的主要因素,并进行单因素分析及多因素logistic回归分析。结果:行超声引导下中心静脉置管的322例患者,首次置管成功者262例(81.37%),失败者60例(18.63%);单因素分析结果:性别、年龄、血管直径、血管部位、肢体有无水肿、体位、操作者工作年限、置管前有无知识宣教与心理护理等8个因素均与超声引导下中心静脉置管失败有关(P<0.05); logistic回归分析结果:性别、血管直径、血管部位、体位等因素是导致超声引导下中心静脉置管失败的危险因素(P<0.05)。结论:超声引导下中心静脉置管有一定失败率,且影响静脉置管失败因素较多,因此应采取针对性措施进行预防与纠正,提高超声引导下中心静脉置管成功率。

Objective:To explore the factors associated with failure of central venous catheterization under ultrasound guidance and to conduct logistic regression analysis in order to reduce its failure rate.Methods:A retrospective analysis of 322 patients with central venous catheterization under ultrasound guidance from January 2014 to December 2016 was conducted'The main factors that lead to the failure of the catheterization were analyzed,and the single factor analysis and multivariate logistic regression analysis were performed.Results:① In the 322 patients who underwent central venous catheterization under ultrasound guidance,262 patients(81.37%)had successful initial catheterization,and 60 patients(18.63%)were failed.② The results of single factor analysis showed that 8 factors including sex,age,blood vessel diameter,vascular location,edema,position,operator's working life,knowledge education and mental nursing before catheterization were all related to the failure of ultrasound guided central venous catheterization(P<0.05).③ Logistic regression analysis showed that the factors such as sex,blood vessel diameter,vascular location,position and other factors were the risk factors for the failure of the central venous catheterization under ultrasound guidance(P<0.05).Conclusion:Ultrasound guided central venous catheterization has a certain failure rate,there are many factors affecting the failure of venous catheterization.Therefore,pertinent measures should be taken to prevent and correct so as to improve the success rate of central venous catheterization under ultrasound guidance.