黎映芹 张文芝

[摘要]目的 分析在中心静脉置管穿刺处采用不同护理方法对感染的影响。方法 选取我院2015年1月～2017年1月行中心静脉置管穿刺的166例患者为观察对象，用计算机随机分为对照组和实验组，每组各83例。对照组实施常规护理，实验组则在常规护理基础上展开细节护理，比较两组置管穿刺的时间、感染发生情况。结果 观察组中心静脉置管穿刺处皮肤出现变化共19例，变化发生率为22.9%，感染4例，感染率为4.8%。对照组中心静脉置管穿刺处皮肤出现变化共24例，变化发生率为28.9%，感染13例，感染率为15.7%；观察组置管穿刺处皮肤变化及感染率更低，差异有统计学意义（P<0.05）。结论 在行中心静脉置管穿刺时，在常规护理的基础上展开细节护理，可减少因置管穿刺造成的感染，该护理方法值得在临床中心静脉置管穿刺时应用。

[关键词]中心静脉；置管穿刺；护理；感染

[中图分类号] R472 [文献标识码] A [文章编号] 1674-4721（2018）8（b）-0212-03

Study on the relationship between two different nursing methods and infection in central venous catheterization

LI Ying-qin ZHANG Wen-zhi

Department of Critical Care Medicine， People′s Hospital of Longhua District in Shenzhen City， Guangdong Province， Shenzhen 518000， China

[Abstract] Objective To analyze the effect of infection on patients under the different nursing methods of central venous catheterization. Methods A total of 166 patients undergoing central venous catheterization from January 2015 to January 2017 in our hospital were selected as observation subjects. The patients were randomly entered into the control group and the experimental group by computer input， 83 cases in each group. The control group patients were given routine nursing care， patients in the experimental group were nurtured on the basis of routine care. The time of catheterization and the infection were compared under two kinds of nursing. Results In the observation group， there were 19 cases of skin changes in central venous catheterization cases， the rate of change was 22.9%， 4 cases of infection， the infection rate was 4.8%. In the control group， there were 24 cases of changes in the skin of central venous catheterization， the rate of change was 28.9%， 13 cases were infected and the infection rate was 15.7%. According to the two different nursing methods， skin changes in the puncture site of the observation group were lower and the infection rate was lower， the difference was statistically significant （P<0.05）. Conclusion During the course of catheterization of central venous catheter， further nursing care can be carried out to further reduce the infection caused by catheterization， which is worth to be used in clinical central venous catheterization.

[Key words] Central vein； Tube puncture； Nursing； Infection

中心静脉置管穿刺属于侵入性的手术操作，该操作经通过上、下腔静脉的分支，以各种途径插入导管，并使导管的前段能达上下腔静脉的根部。在此过程中若不注意则很可能导致置管穿刺处发生感染，对患者治疗及病情发展均会产生不利影響。因此，在行中心静脉置管穿刺时，护理人员需对置管穿刺部位实施护理，且护理过程需从留置导管开始到穿刺操作结束，确保整个过程不出现问题，由此减少患者穿刺部位的菌落数，降低感染发生率[1-3]。而具体如何实施置管穿刺部位的护理，以何种方式展开护理干预，本研究则重点选取行中心静脉置管穿刺的166例患者展开观察，通过实施常规护理和细节护理，分析和观察患者护理期间感染的发生情况，现报道如下。……