局部外用聚维酮碘乳膏对烧伤部位深静脉导管相关性感染的预防作用

Clinical Effect of Topical Povidone-iodine Ointment Used to Decrease the Incidence of Deep Venous Catheter-related Dnfections in Burn site

目的:探讨局部外用聚维酮碘乳膏对烧伤部位深静脉导管相关性感染的预防效果。方法:对2014年4月-2018年10月68例中大面积烧伤患者经烧伤创面进行深静脉穿刺留管,随机分成观察组和对照组,对照组予常规消毒换药处理,观察组予局部加用聚维酮碘乳膏;比较2组的不良反应及导管相关性感染的发生率。结果:2组均无脱管、堵管及过敏等不良事件,观察组部分患者在外涂聚维酮碘乳膏后有烧灼感,数分钟后即消失,无其他不适。观察组置管后引发CAI2例(发生率0.9%),CAB1例(发生率0.4%),对照组置管后引发CAI9例(发生率4.2%),CAB7例(发生率3.3%),2组比较均有显著的统计学差异(P<0.05)。结论:聚维酮碘乳膏局部应用于深静脉置管部位可显著降低导管相关性感染发生率,延长留管时间,临床效果好,价格低廉,且能够减少换药次数,减轻工作量,可以推广使用。

Objective:To investigate clinical efect of topical povidone-iodine ointment used to decrease the incidence of deep venous catheter-related infections in burn site.Method:From April 2014 to October 2018,68 thermally injured patients with medium to large burmn sizes who needed deep venipuncture and indwelling catheters were involved in the study.They were randomly allocated into observa-tion group and control group.The patients in control group were treated with routine disinfection and dressing change,while the patients in observation group were treated with topical povidone-iodine ointment in addition to routine disinfection and dressing change.The adverse reactions and incidence of catheter-related infections were compared between the two groups.Results:There were no adverse events such as accidental detubation,blockage and allergy in both groups.In the observation group,some patients had burning sensation after topical povidone-iodine ointment,which disappeared in a few minutes without any other disconfort.Catheter-related soft tissue infection occurred in 2 cases in the observation group after catheterization(incidence rate 0.9%),while 9 cases in the control group(4.2%)Catheter-related bacteremia occurred in 1 case in the observation group during indwelling catheter(0.4%),while 7 cases in the con-trol group(3.3%).There were signifcant differences between the two groups(P<0.05).Conclusion:Local application of povidone-iodine ointment in deep vein catheterization can significantly reduce the incidence of catheter-related infection,prolong the time of catheterization,have good clinical effect and low cost,and can reduce the workload.