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一项在外科部门使用无针连接器评估外周静脉导管相关性静脉炎的前瞻性临床试验。

A prospective clinical trial to assess peripheral venous catheter-related phlebitis using needleless connectors in a surgery department.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel; Galilee Medical Center, Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel.

Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel; Galilee Medical Center, Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel.

出版信息

Am J Infect Control. 2017 Oct 1;45(10):1139-1142. doi: 10.1016/j.ajic.2017.05.001.

Abstract

BACKGROUND

The use of intravascular catheters is often complicated by phlebitis, which is associated with increased morbidity and extended duration of hospitalization. We conducted a study to investigate the impact of needleless intravenous access devices on the rate of phlebitis in peripheral venous catheters (PVCs).

METHODS

We prospectively recruited patients in 2 phases. The first group was treated with a regular cap, and the second group was treated with a needleless connector. The incidence of catheter-related phlebitis (CRP) was recorded as the primary end point.

RESULTS

A total of 620 PVCs using regular caps were inserted into 340 patients and CRP rates were recorded. In the second phase of the study, 169 PVCs using needleless connectors were inserted into 135 patients. In the group treated with the regular cap, the CRP rate was 60% compared with 7% in the group treated with the needleless cap (P <.001). Consequently, the number of catheter replacements was decreased from 1.9 on average to 1.3 (P <.001). In both phases, patients who developed phlebitis had a statistically significant longer mean hospitalization period (P <.001), as were patients in the regular cap group (P <.01).

CONCLUSIONS

The use of needleless connectors was found to be associated with a significant reduction of CRP in peripheral veins in a surgery department setting. The decreased morbidity resulted in a lower number of catheter replacements and duration of hospitalization.

摘要

背景

血管内导管的使用常伴有静脉炎,这会增加发病率并延长住院时间。我们进行了一项研究,旨在调查无针静脉接入装置对周围静脉导管(PVC)静脉炎发生率的影响。

方法

我们分两阶段前瞻性招募患者。第一组使用常规帽,第二组使用无针连接器。记录导管相关性静脉炎(CRP)的发生率作为主要终点。

结果

共插入 340 例患者的 620 根 PVC 采用常规帽,记录 CRP 发生率。在研究的第二阶段,135 例患者插入了 169 根无针连接器的 PVC。使用常规帽的组中,CRP 发生率为 60%,而使用无针帽的组中为 7%(P<.001)。因此,平均更换导管的数量从 1.9 根减少到 1.3 根(P<.001)。在两个阶段中,发生静脉炎的患者的平均住院时间都显著延长(P<.001),常规帽组的患者也是如此(P<.01)。

结论

在外科部门环境中,使用无针连接器与周围静脉 CRP 的显著减少相关。发病率的降低导致更换导管的数量和住院时间减少。

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