CAJ | 학술논문

目的：探讨两种不同的深静脉导管固定方法对深静脉置管相关性感染的影响。方法选择广东省佛山市顺德区中医院ICU收治的140例行锁骨下静脉置管患者为研究对象，将所有患者随机分为观察组（n=70）和对照组（n=70），观察组采用改良导管固定方法，不使用蝶形夹，单纯缝线固定，而对照组采用传统固定方法，使用蝶形夹皮肤缝合固定，2组置管方式及后期维护相同。分别记录2组导管留置时间、脱管例数及导管相关感染例数。结果观察组导管留置时间为（27.5±11.7）d，对照组导管留置时间为（17.5±12.1）d，观察组导管留置时间明显长于对照组，2组比较，差异有统计学意义；2组脱管例数分别为5例、3例，脱管率比较，差异无统计学意义；观察组和对照组的导管相关性感染例数分别为6例、11例，2组的导管日感染率分别为3.1‰、8.98‰，观察组的导管相关日感染率明显低于对照组，2组比较，差异有统计学意义。结论不使用蝶形夹的改良导管固定方法较传统方法可明显延长留管时间，并降低导管相关感染的发生率，且并不增加脱管率，值得推广应用。
목적：탐토량충불동적심정맥도관고정방법대심정맥치관상관성감염적영향。방법선택광동성불산시순덕구중의원ICU수치적140례행쇄골하정맥치관환자위연구대상，장소유환자수궤분위관찰조（n=70）화대조조（n=70），관찰조채용개량도관고정방법，불사용접형협，단순봉선고정，이대조조채용전통고정방법，사용접형협피부봉합고정，2조치관방식급후기유호상동。분별기록2조도관류치시간、탈관례수급도관상관감염례수。결과관찰조도관류치시간위（27.5±11.7）d，대조조도관류치시간위（17.5±12.1）d，관찰조도관류치시간명현장우대조조，2조비교，차이유통계학의의；2조탈관례수분별위5례、3례，탈관솔비교，차이무통계학의의；관찰조화대조조적도관상관성감염례수분별위6례、11례，2조적도관일감염솔분별위3.1‰、8.98‰，관찰조적도관상관일감염솔명현저우대조조，2조비교，차이유통계학의의。결론불사용접형협적개량도관고정방법교전통방법가명현연장류관시간，병강저도관상관감염적발생솔，차병불증가탈관솔，치득추엄응용。
Objective To explore the affection of the two different fixation methods of deep venous catheter on deep venous catheter-relation infections. Methods We observed 140 cases on subclavian vein intubations of ICU in our hospital. All the cases were divided into the observation group and the control group with 70 cases in each group, The observation group was treated with modified catheter fixing method, we didn’t use the butterfly clip, and we used simple suture fixation;While the control group was used the traditional fixing method and the butterfly clip skin suture, but the catheter and maintenance is the same as the two groups. We recorded and catheter indwelling time, the number of tube and catheter related infection cases. Results There was a significant difference, the improved method group was longer than that of the traditional method of indwelling time group;the improved methods of fixation group catheter indwelling time was (27.5 ± 11.7) days, but the traditional method of fixed group of catheter indwelling time was (17.5 ± 12.1) days, The decannulation rate showed no significant difference, the two group of tube off the number of cases were 5 cases, 3 cases;there was a significant difference between the days of the observation group, the catheter related infection rate was significantly lower than the control group. The catheter related the observation group and the control group of infection cases were 6 cases, 11 cases, the two groups of catheter day’s infection rate was 3.1‰, 8.98‰. Conclusion We didn’t use the improved catheter fixation methods butterfly clip is superior to the traditional methods. Because It can be obviously prolong the indwelling time, and it can reduce the incidence of catheter related infection, and It isn’t also increase the decannulation rate. So we deem it is worth promoting the application.