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[聚氨酯与聚乙烯:中心静脉置管感染并发症的体内随机研究]

[Polyurethane versus polyethylene: in vivo randomized study of infectious complications of central catheterization].

作者信息

Poisson D M, Touquet S, Bercault N, Arbeille B

机构信息

Laboratoire de Microbiologie, Centre Hospitalier Régional d'Orléans, France.

出版信息

Pathol Biol (Paris). 1991 Sep;39(7):668-73.

PMID:1758717
Abstract

Polyurethane (PU) and polyethylene (PE) catheters were distributed by randomization among adult ICU patients to evaluate the impact of the catheter polymer on the rate of catheter-related sepsis (CRS). The two catheters were otherwise strictly identical. Three hundred central venous catheters were randomized and inserted in the subclavian or internal jugular vein, at the discretion of the clinician. Mean duration of insertion was 9.2 (+/- 3) days for both catheter types and mean number of line openings was 159 (+/- 60). A bacteriologic culture using a variant of Maki's technique was performed on the 205 catheters removed before patient discharge. No significant differences were found between the two catheters. Total number of tip infections was 33 and polyurethane and polyethylene prevalence ratio was 0.7. A clinical evaluation was performed for the 183 catheters inserted for a least 48 hours (in 142 patients). Patients were divided into four clinical categories according to previously reported definitions (Brun-Buisson et al., 1987). Clinical tip-infection rate was 4.4% and polyurethane and polyethylene ratio was 0.7. For three additional catheters (1.6%), only the Luer-lock was infected. These three catheters were made of polyethylene and were inserted into the internal jugular vein. The Luer-lock was made of polypropylene.

摘要

通过随机分配,将聚氨酯(PU)导管和聚乙烯(PE)导管用于成年重症监护病房(ICU)患者,以评估导管聚合物对导管相关败血症(CRS)发生率的影响。除此之外,这两种导管在其他方面严格相同。300根中心静脉导管被随机分配,并由临床医生决定插入锁骨下静脉或颈内静脉。两种导管的平均插入持续时间均为9.2(±3)天,平均管路开口次数为159(±60)。对205根在患者出院前拔除的导管采用Maki技术的一种变体进行了细菌培养。两种导管之间未发现显著差异。尖端感染总数为33例,聚氨酯与聚乙烯的患病率比为0.7。对183根(涉及142例患者)插入至少48小时的导管进行了临床评估。根据先前报道的定义(Brun - Buisson等人,1987年),将患者分为四个临床类别。临床尖端感染率为4.4%,聚氨酯与聚乙烯的比率为0.7。另外有3根导管(1.6%)仅鲁尔锁被感染。这三根导管由聚乙烯制成,插入颈内静脉。鲁尔锁由聚丙烯制成。

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