CAJ | 학술논문

目的：探讨超声引导下静脉穿刺对降低导管相关性血流感染的临床研究。方法选取2010年6月至2013年6月该院行血管内导管留置术的240例患者作为研究对象，按照置管方式不同分为超声引导组（125例）和传统对照组（115例），比较2种静脉穿刺置管方式的穿刺效果，并观察2组在导管相关性血行感染发生率上的差异。结果超声引导组和对照组穿刺时间分别为（3．4±1．3）和（9．8±4．1）min ，差异有统计学意义（P＜0．05）；超声引导组颈内静脉穿刺、锁骨下静脉穿刺和总的静脉穿刺成功率分别为90．1％、88．9％、89．6％，而对照组分别为64．6％、62．0％、63．5％，差异有统计学意义（ P＜0．05）；对照组颈内静脉穿刺、锁骨下静脉穿刺和总的静脉穿刺并发症发生率分别为12．3％、14．0％、13．0％，其中导管相关性血行感染并发症发生率分别为7．7％、8．0％、7．8％，而超声引导组尚无一例并发症发生，差异有统计学意义（ P＜0．01、P＜0．05）。结论超声引导下静脉穿刺能明显缩短穿刺时间并提高首次穿刺成功率，并能明显降低导管相关性血流感染发生率。
목적：탐토초성인도하정맥천자대강저도관상관성혈류감염적림상연구。방법선취2010년6월지2013년6월해원행혈관내도관류치술적240례환자작위연구대상，안조치관방식불동분위초성인도조（125례）화전통대조조（115례），비교2충정맥천자치관방식적천자효과，병관찰2조재도관상관성혈행감염발생솔상적차이。결과초성인도조화대조조천자시간분별위（3．4±1．3）화（9．8±4．1）min ，차이유통계학의의（P＜0．05）；초성인도조경내정맥천자、쇄골하정맥천자화총적정맥천자성공솔분별위90．1％、88．9％、89．6％，이대조조분별위64．6％、62．0％、63．5％，차이유통계학의의（ P＜0．05）；대조조경내정맥천자、쇄골하정맥천자화총적정맥천자병발증발생솔분별위12．3％、14．0％、13．0％，기중도관상관성혈행감염병발증발생솔분별위7．7％、8．0％、7．8％，이초성인도조상무일례병발증발생，차이유통계학의의（ P＜0．01、P＜0．05）。결론초성인도하정맥천자능명현축단천자시간병제고수차천자성공솔，병능명현강저도관상관성혈류감염발생솔。
Objective To conduct the clinical study on ultrasound‐guided venipuncture for reducing the cathe‐ter‐related bloodstream infections .Methods 240 patients undergoing intravascular catheter indwelling operation in our hospital from June 2010 to June 2013 were selected as the study subjects and divided into the ultrasound‐guided group(125 cases) and the traditional control group (115 cases) according to the different catheter indwelling modes . The venipuncture effects were compared between the two kinds of venipuncture catheter indwelling mode and the differences in the occurrence rate of catheter‐related bloodstream infection was observed in the two groups .Results The venipuncture time of the ultrasound‐guided group and the control group were (3 .4 ± 1 .3) and (9 .8 ± 4 .1) min respectively ,the difference was statistically significant(P<0 .05);the success rates of internal carotid venipuncture , subclavian venipuncture and total venipuncture in the ultrasound‐guide group were 90 .1% ,88 .9% and 89 .6% re‐spectively ,while which in the control group were 64 .6% ,62 .0% and 63 .5% respectively ,the differences were statis‐tically significant(P<0 .05);the complication occurrence rates of internal carotid venipuncture ,subclavian venipunc‐ture and total venipuncture in the control group were 12 .3% ,14 .0% and 13 .0% respectively ,and the occurrence rates of catheter‐related bloodstream infection were 7 .7% ,8 .0% and 7 .8% respectively ,while no case of complica‐tion occurred in the ultrasound‐guided group ,the difference was statistically significant(P<0 .01 ,P<0 .05) .Conclu‐sion Ultrasound‐guided venipuncture can significantly shorten the puncture time ,improve the once success rate and can significantly reduce the occurrence rate of catheter‐related bloodstream infection .