摘要
目的 研究重型颅脑损伤患者长期静脉输液药物、治疗及静脉高营养的有效途径 ,寻求预防导管相关性感染的有效方法。方法 137例重型颅脑损伤所致昏迷患者随机分为两组 ,试验组 (n =6 9)采用经皮下隧道股静脉穿刺置管法建立静脉通道 ;对照组 (n =6 8)采用传统股静脉穿刺置管法。均经此通道常规输液及补充静脉高营养素。穿刺点每周换药 1次 ,细菌培养 1次 ,发热患者行血培养 ,拔管时取管尖培养。观察导管阻塞、脱落、导管相关性感染等并发症以及留管时间等。结果 试验组留管时间长于对照组 ,导管脱落及相关性感染和穿刺点感染等并发症的发生较对照组少 ,差异有显著性(P <0 .0 5 )。而导管阻塞的发生两组无差异 (P >0 .0 5 )。结论 经皮下隧道股静脉穿刺置管能有效降低导管相关性感染的发生率 ,延长留管时间。
Objective To study the effective means of providing long term vein drug infusion ,therapy and rich nutrition to the patients with severe craniocerebral trauma and to seek effective methods of preventing related infection caused by the canal.Methods 137 unconscious severe craniocerebral injured patients were divided into two groups in random: experimental group (n=69) and control group (n=68). The patients in experimental group were set up a vein routeway through subcutaneous tunnel of femoral vein puncture, while patients in the control group were set up a vein routeway through traditional femoral vein puncture. Both the routeways were used to give regular infusion and to supplement rich nutrition. The medicine used in puncture place was changed once a week and the germiculture was performed also once a week. The blood was used to do germiculture on the condition that the patients had got a fever and the canal tine was utilized when the vein canal was removed. Observe the complications of canal shedding, related infection and the puncture place infection and the time of retaining the canal. Results The retaining canal time of experimental group was longer than that of the control group, and the puncture place infection of the experimental group was less than that of the control group. The difference was very remarkable (P<0.05 and P<0.01). But the occurrence rate of canal blocking of the two groups has no difference (P>0.05). Conclusions The occurrence rate of canal related infection can be reduced and the retaining canal time can be extended by means of setting up vein routeway through subcutaneous tunnel of femoral vein puncture. The method can be applied to the patients in need of long term keeping transfusing passage.
出处
《现代护理》
2003年第7期502-504,共3页
Modern Nursing
