不同消毒法应用于超声引导中心静脉穿刺的消毒效果及成像清晰度比较研究

Comparative Study on Disinfection Effect and Imaging Clarity of Different Disinfection Methods in Ultrasound-guided Central Venous Puncture

目的 旨在探讨不同消毒方法应用于超声引导下中心静脉穿刺的消毒效果及超声成像清晰度。方法 选取某医院手术室超声引导下行右侧颈内静脉穿刺的126名患者为研究对象,随机分为氯己定消毒组、碘伏消毒组和氯己定+碘伏消毒组3组,每组患者42名。每组患者在使用不同方法消毒后,行超声引导下颈内静脉穿刺,对三组患者的消毒效果、成像清晰度及敷贴粘贴牢靠度等进行统计学比较。结果 三组患者在消毒前及消毒后的细菌数量以及消毒合格率等差异均无统计学意义(p>0.05),三组患者的超声成像清晰度率的差异有统计学意义(p<0.05),三组患者在消毒后的敷贴粘贴牢靠率差异有统计学意义(p<0.05)。结论 使用2%葡萄糖酸氯己定+70%乙醇对中心静脉穿刺区域进行消毒后,再使用有效碘5%聚维酮碘对超声探头区域进行消毒,消毒效果更好,超声成像清晰,敷贴粘合牢固,有利于减少感染发生的几率。

Objective To investigate the disinfection effect and ultrasound imaging clarity of different disinfection methods applied to ultrasound-guided central venous puncture. Methods A total of 126 patients who underwent ultrasound-guided right internal jugular vein puncture in the operating room of a hospital were selected as the research objects, and they were randomly divided into 3 groups:chlorhexidine disinfection group, iodophor disinfection group and chlorhexidine + iodophor disinfection group, with 42 patients in each group. After disinfection by different methods, patients in each group underwent ultrasound-guided jugular vein puncture. The disinfection effect, imaging clarity and the sticking firmness of the application of the three groups were statistically compared. Results There was no significant difference in the number of bacteria and the qualified rate of disinfection among the three groups before and after disinfection(p>0.05). There was a statistically significant difference in ultrasound imaging clarity among the three groups of patients(p<0.05). There was a statistically significant difference among the three groups in the sticking firmness rate after disinfection(p<0.05). Conclusion Using 2% chlorhexidine gluconate + 70% ethanol to disinfect the central venous puncture area, and then using available iodine 5% povidone iodine to disinfect the ultrasonic probe area have better disinfection effect, with more clear ultrasonic image, and firmer stickiness of application, which helps to reduce the incidence of infection.