不同消毒方法对超声引导锁骨下静脉穿刺超声成像和敷贴牢固度的影响

Effects of different disinfection methods on ultrasound imaging and application firmness of ultrasound-guided subclavian vein puncture

目的探讨不同消毒方法对超声引导锁骨下静脉穿刺超声成像和敷贴牢固度的影响。方法选取超声引导锁骨下静脉穿刺138例患者为研究对象,随机分为氯己定醇组、碘伏组和氯己定醇+碘伏组3组,每组46例,分别使用氯己定醇、碘伏和氯己定醇+碘伏消毒。对3组患者的消毒效果、超声成像和敷贴粘贴情况进行比较。结果3组患者消毒前后穿刺点的菌群计数及消毒合格率比较,差异均无统计学意义(P>0.05);氯己定醇组患者穿刺时超声成像清晰率显著低于碘伏组和氯己定醇+碘伏组(P<0.05),碘伏组患者穿刺后24 h的敷贴起翘或脱落率显著高于氯己定醇组和氯己定醇+碘伏组(P<0.05)。结论先使用氯己定醇消毒穿刺区域2次,再使用碘伏对超声探查区域消毒1次,可以使超声引导锁骨下静脉穿刺患者获得满意的消毒效果,同时超声成像更清晰,敷贴粘贴更牢固。

Objective To investigate the effects of different disinfection methods on ultrasound imaging and application firmness of ultrasound-guided subclavian vein puncture.Methods A total of 138 patients received ultrasound-guided subclavian vein puncture were selected as the study subjects and randomly divided into the chlorhexidine alcohol group,the iodophor group and the chlorhexidine alcohol+iodophor group,with 46 cases in each group.They were disinfected with chlorhexidine alcohol,iodophor,and chlorhexidine alcohol and iodophor,respectively.The disinfection effect,ultrasound imaging and application fixation of patients in the three groups were compared.Results There was no statistically significant difference in the bacterial count or disinfection qualification rate of the puncture sites before and after disinfection of patients among the three groups(P>0.05).The ultrasound imaging clarity rate during puncture in the chlorhexidine alcohol group was significantly lower than those in the iodophor group and the chlorhexidine alcohol+iodophor group(P<0.05);while the rate of sticking up or shedding of application in the iodophor group 24 hours after puncture was significantly higher than those in the chlorhexidine alcohol group and the chlorhexidine alcohol+iodophor group(P<0.05).Conclusion Disinfecting the puncture area twice with chlorhexidine alcohol and then disinfecting the ultrasound exploration area once with iodophor can obtain satisfactory disinfection effect for patients undergoing ultrasound-guided subclavian vein puncture,with clearer ultrasound imaging and stronger adhesion of the application at the same time.