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目的探讨二维实时超声引导下深静脉穿刺置管对导管相关性感染发生率的影响。方法选择2014年8月至2015年12月期间深圳市人民医院ICU收治的300例深静脉穿刺置管的危重症患者为研究对象,根据随机数表法分为观察组与对照组,每组150例,对照组患者采用体表标志定位进行穿刺置管,观察组患者则在二维实时超声引导下进行,比较两组患者的深静脉穿刺置管相关指标。结果观察组患者的穿刺时间为(6.16±2.38)min,明显短于对照组的(7.89±3.16)min,一次穿刺成功率及导管留置时间分别为97.33%和(13.54±4.18)d,均高于对照组的88.67%和(10.72±3.27)d,导管相关性感染发生率为4.67%,明显低于对照组的10.67%,差异均有统计学意义(P<0.05)。结论二维实时超声引导深静脉穿刺置管能有效提高穿刺成功率,减少穿刺时间,进而减少危重患者导管相关性感染的发生风险。
Objective To investigate the effect of deep venous catheterization on the incidence of catheter-related infections under the guidance of two-dimensional real-time ultrasound. Methods From August 2014 to December 2015, 300 cases of critically ill patients with deep venous catheterization in ICU of Shenzhen People’s Hospital were divided into observation group and control group according to the random number table method, with 150 For example, the patients in the control group were treated by puncture and catheterization with the location of body surface markers. The patients in the observation group were guided by real-time two-dimensional ultrasound. The indexes of deep vein puncture and catheterization were compared between the two groups. Results The puncture time in the observation group was (6.16 ± 2.38) min, which was significantly shorter than that in the control group (7.89 ± 3.16) min. The successful rate of puncture and catheter indwelling were 97.33% and 13.54 ± 4.18 d respectively In the control group, 88.67% and (10.72 ± 3.27) days, the incidence of catheter-related infection was 4.67%, which was significantly lower than that of the control group (10.67%, P <0.05). Conclusions Two-dimensional real-time ultrasound-guided deep venous catheterization can effectively improve the puncture success rate, reduce the puncture time and reduce the risk of catheter-related infection in critically ill patients.