Inoue Y, Nezu R, Matsuda H, Fujii M, Nakai S, Wasa M, Takagi Y, Okada A
First Department of Surgery, Osaka University Medical School, Japan.
JPEN J Parenter Enteral Nutr. 1992 Nov-Dec;16(6):581-5. doi: 10.1177/0148607192016006581.
A prospective study was carried out to determine the clinical effect of a newly devised catheter connection method (I system) and piggyback access system. Previous studies have demonstrated that the I system avoided bacterial contamination in vitro during tubing change that Luer-Lock connectors did not. The purpose of this study was to investigate the ability of this device coupled with a new closed-system piggyback technique for multipurpose access to reduce catheter-related sepsis in clinical practice. Two hundred and thirty patients receiving total parenteral nutrition were divided into two groups. Group I (n = 106) used the I system connector and group L (n = 124) used a Luer-Lock connector. Catheters in both groups were used for multipurpose access for infusion and blood sampling. In group L, a three-way stopcock and/or pig-gyback system was used for multiple access. In group I, a newly designed closed-system piggyback was used. The incidence of catheter-related sepsis was significantly lower in group I (1.89%/catheter) than in group L (12.10%/catheter) (p < .01, chi 2 analysis), and the average duration of use of each catheter was significantly longer in group I than in Group L (p < .01 by generalized Wilcoxon test). The results of this clinical study suggest that the newly designed connection method and piggyback access system are able to reduce catheter-related sepsis.
进行了一项前瞻性研究，以确定一种新设计的导管连接方法（I系统）和背驮式接入系统的临床效果。先前的研究表明，在体外更换输液管期间，I系统可避免细菌污染，而鲁尔锁连接器则不能。本研究的目的是调查这种装置与一种新的用于多用途接入的封闭式背驮技术相结合，在临床实践中减少导管相关败血症的能力。230例接受全胃肠外营养的患者被分为两组。第一组（n = 106）使用I系统连接器，第二组（n = 124）使用鲁尔锁连接器。两组的导管均用于输液和采血的多用途接入。在第二组中，使用三通旋塞和/或背驮式系统进行多次接入。在第一组中，使用了一种新设计的封闭式背驮系统。第一组的导管相关败血症发生率（1.89%/导管）显著低于第二组（12.10%/导管）（p <.01，卡方分析），并且第一组中每个导管的平均使用时间显著长于第二组（广义威尔科克森检验，p <.01）。这项临床研究的结果表明，新设计的连接方法和背驮式接入系统能够减少导管相关败血症。
