中心静脉置管局部换药敷料的比较研究

目的探讨中心静脉置管患者局部不同季节换药的最佳敷料,减少局部感染并发症,使患者舒适,降低医疗费用。方法将中心静脉置管的患者随机分为2组,每组各100例,透明敷料组以一次性透明敷料覆盖固定。无菌纱布组以传统的无菌纱布覆盖固定。对两组局部感染情况、与冬春季与夏秋季感染的关系及敷料留置的时间进行分析、比较。结果透明敷料组局部感染9例,无菌纱布组局部感染2例,两组均无严重感染病例,差异有显著意义(P<0.05),透明敷料组夏秋季局部感染率明显高于春冬季;两组敷料在使用时间上无菌纱布组明显长于透明敷料组(P<0.05);两组敷料在消耗费用上,透明敷料的换药费用明显高于无菌纱布的换药费用,尤其在夏秋季。结论两组方法对比表明,中心静脉置管局部换药应根据患者的具体情况和季节的不同选择敷料,作者推荐春冬季可选择透明膜敷料,夏秋季使用无菌纱布(棉质)敷料。

RESEARCH OF THE LOCAL DRESSING WITH CENTRAL CATHETERIZATION

Objective To research the best dressing for patients with central venous catheterization in different seasons. Methods The patients with central venous catheterization were divided randomly into two groups. Each had 100 cases. The experimental group used the transparent dressing while the control one used sterile gauze. The local infection and the relation between infection and seasons were observed and the results were analyzed. Results 9 cases had local infection in experimental group while 2 cases had local infection in control one. Though there was no serious infection in the two groups, there was significant difference between the two groups (P<0.05). The rate of local infection in the experimental group was higher in summer and autumn than in winter and spring (P<0.05) and its cost is much higher than that of the control group, especially in summer and autumn while the period time of using sterile gauze is remarkably longer than that of using transparent dressing. Conclusions Transparent dressing had better be selected in winter and spring while sterile gauze had better be selected in summer and autumn.