中线静脉置管对行静脉治疗的颅内感染患者的影响

Influence of midline venous catheterization on patients with intracranial infection undergoing intravenous therapy

目的探讨中线静脉置管对行静脉治疗的颅内感染患者的影响。方法选取郑州大学第一附属医院2019年8月至2021年11月收治的颅内感染患者118例进行前瞻性研究, 根据静脉置管方法不同分为两组, 留置针组(采用外周静脉留置针形式):59例, 男31例, 女28例, 年龄39~75岁;中线组(采用中线静脉置管形式):59例, 男36例, 女23例, 年龄36~72岁。比较两组穿刺成功率、置管情况、留置时间、穿刺次数、并发症情况、使用成本、患者满意度。导管留置时间及穿刺次数、使用成本以均数±标准差(xˉ±s)表示, 采用独立样本t检验进行均数比较, 并发症用率(%)表示, 采用χ~2检验进行率的比较, 患者满意度用率(%)表示, 使用秩和检验进行组间比较。结果与留置针组比较, 中线组一次性成功率[91.52%(54/59)]较高(χ^(2)=5.081, P<0.05), 导管/留置针滑脱[5.09%(3/59)]、意外拔管率[1.70%(1/59)]均较低(χ^(2)=4.236、11.670, 均P<0.05);中线组留置时间长于留置针组, 穿刺次数短于留置针组(t=133.261、50.935, 均P<0.05);中线组并发症总发生率为3.39%(2/59), 低于留置针组[20.34%(12/59)], 患者满意度为96.61%(57/59), 高于留置针组[79.66%(47/59)];使用成本组间比较差异无统计学意义(t=0.445, P>0.05)。结论与外周静脉留置针相比, 中线静脉置管可增长导管留置时间、减少穿刺次数, 降低并发症发生率, 提升患者满意度, 且不会增加使用成本。

Objective To investigate the effect of midline venous catheterization on patients with intracranial infection who received intravenous therapy.Methods A total of 118 patients with intracranial infection who were admitted to The First Affiliated Hospital of Zhengzhou University from August 2019 to November 2021 were selected for the prospective study.According to the different methods of intravenous catheterization,they were divided into an indwelling needle group and a midline group,with 59 cases in each group.The indwelling needle group had 31 males and 28 females who were 39-75 years old,and peripheral-intravenously indwelled needles.The midline group had 36 males and 23 females who were 36-72 years old,and took midline venous catheterization.The puncture success rates,catheter placement,indwelling times,puncture times,complications,usage costs,and patient satisfaction were compared between the two groups.The indwelling time,puncture times,and cost were expressed as(-x±s),and were compared between these two groups by independent-sample t test.The complications were expressed as cases (%), and were compared by χ^(2) test. The satisfaction was expressed as cases (%), and compared by rank sum test. Results Compared with the indwelling needle group, the midline group had a higher one-time success rate [91.52%(54/59), χ^(2)=5.081, P<0.05] and lower catheter/ indwelling needle slippage and accidental extubation rates [5.09%(3/59)、1.70%(1/59),χ^(2)=4.236、 11.670,all P<0.05]. The indwelling time in the midline group was longer than that in the indwelling needle group , and the number of punctures was lower than that in the indwelling needle group (t= 133.261、50.935,all P<0.05). The total incidence of complications in the midline group was 3.39% (2/59), which was lower than that in the indwelling needle group 20.34% (12/59), and the patient satisfaction was higher than that in the indwelling needle group [96.61% (57/59) vs. 79.66% (47/ 59)]. There was no statistical difference in the cost between the two groups (t=0.445, P>0.05). Conclusion Compared with peripheral venous catheterizaiotn, midline venous catheterization can increase the catheter indwelling time, reduce the number of punctures and incidence of complications, and improve patient satisfaction without increasing the cost.