Résumé
Objective To explore the success rate and safety of axillary venipuncture catheterization with ultrasound localization and homologous surface localization(Magney).Method A total of 80 patients were enrolled in the EICU from January 2017 to September 2018.They were randomly assigned to the Magney method(n=35)and the ultrasound-guided method(n=45).The number of successful punctures,success rate and complications were recorded.Results Compared with ultrasound-guided method,the one-time success rate(25.7％vs 68.9％,P＜0.01),puncture greater than 2 times(34.3％vs 11.1％,P=0.012),and total success rate(82.9％vs 100％,P=0.004)in Magney method were significantly different.Both of the two puncture methods were mis-invasive,and the difference was not statistically significant.In Magney method 2 patients occurred hematoma and 1 patient brachial plexus injury,but no infection occurred within 48 h.While no such occurrence was found in ultrasound-guided method.Conclusion Ultrasound-guided method axillary venipuncture is a safe and effective method of central venous catheterization,which has higher success rate and safety than Magney method.
Résumé
Objective@#To compare the effects of various interventions on the incidence of central line-associated bloodstream infection (CLABSI) .@*Methods@#The clinical data of 218 patients with central venous catheterization were retrospectively analyzed. Infected patients were treated as CLABSI group and non-infected patients as control group.@*Results@#Of the 218 patients, 24 patients were developed CLABSI. There was no significant difference in sex, age, primary infection status and puncture site between CLABSI group and control group. Univariate analysis showed that axillary vein puncture could significantly reduce the incidence of CLABSI (P=0.028), and the infection rate of axillary vein puncture per 1000 days under B-ultrasound was significantly reduced by 0.93‰. The average indwelling days of deep venous catheter in patients with pulse puncture were significantly longer than those in other groups (47.32 days vs 19.90 days). The average indwelling days in patients with axillary vein puncture positioned by B ultrasound were longer than those in patients with other parts of vein puncture positioned by B ultrasound (P < 0.05). Logistic multiple regression analysis showed that the main risk factors for CLABSI were anatomically located puncture (P = 0.031) and non-axillary venous catheterization (P = 0.068).@*Conclusions@#Choosing axillary vein as the position of deep venous catheterization and using ultrasound-guided central venous puncture can reduce the incidence of CLABSI and prolong the average catheterization time.
Résumé
Objective To compare the effects of various interventions on the incidence of central line-associated bloodstream infection (CLABSI).Methods The clinical data of 218 patients with central venous catheterization were retrospectively analyzed.Infected patients were treated as CLABSI group and non-infected patients as control group.Results Of the 218 patients,24 patients were developed CLABSI.There was no significant difference in sex,age,primary infection status and puncture site between CLABSI group and control group.Univariate analysis showed that axillary vein puncture could significantly reduce the incidence of CLABSI (P=0.028),and the infection rate of axillary vein puncture per 1000 days under B-ultrasound was significantly reduced by 0.93‰.The average indwelling days of deep venous catheter in patients with pulse puncture were significantly longer than those in other groups (47.32 days vs 19.90 days).The average indwelling days in patients with axillary vein puncture positioned by B ultrasound were longer than those in patients with other parts of vein puncture positioned by B ultrasound (P ＜ 0.05).Logistic multiple regression analysis showed that the main risk factors for CLABSI were anatomically located puncture (P =0.031) and non-axillary venous catheterization (P =0.068).Conclusions Choosing axillary vein as the position of deep venous catheterization and using ultrasound-guided central venous puncture can reduce the incidence of CLABSI and prolong the average catheterization time.
Résumé
Objective@#To explore the success rate and safety of axillary venipuncture catheterization with ultrasound localization and homologous surface localization (Magney).@*Method@#A total of 80 patients were enrolled in the EICU from January 2017 to September 2018. They were randomly assigned to the Magney method (n=35) and the ultrasound-guided method (n=45). The number of successful punctures, success rate and complications were recorded.@*Results@#Compared with ultrasound-guided method, the one-time success rate (25.7% vs 68.9%, P<0.01), puncture greater than 2 times (34.3% vs 11.1%, P=0.012), and total success rate (82.9% vs 100%, P=0.004) in Magney method were significantly different. Both of the two puncture methods were mis-invasive, and the difference was not statistically significant. In Magney method 2 patients occurred hematoma and 1 patient brachial plexus injury, but no infection occurred within 48 h. While no such occurrence was found in ultrasound-guided method.@*Conclusion@#Ultrasound-guided method axillary venipuncture is a safe and effective method of central venous catheterization, which has higher success rate and safety than Magney method.