Martin C, Bruder N, Papazian L, Saux P, Gouin F
Department of Intensive Care and Trauma Center, Nord Hospital, Marseilles, France.
Acta Anaesthesiol Scand. 1998 Jan;42(1):52-6. doi: 10.1111/j.1399-6576.1998.tb05080.x.
The aim of this study was to determine the rate of infectious complications following axillary vein cannulation and to compare to that observed after internal jugular vein catheterization.
A prospective comparative open study was carried out to determine the rate of infectious complications related to the use of catheters inserted via the axillary vein or the internal jugular vein. During the study period all patients submitted to central venous catheterization were evaluated. A total of 141 patients entered and completed the study. Catheter insertion sites were either the axillary vein punctured in the axilla, or the internal jugular vein punctured using an anterior approach. Catheter tips were cultured using a quantitative technique. Clinical information pertaining to the analysis was prospectively collected.
A total of 141 catheters from 141 patients entered was studied. Clinical characteristics and risk factors for catheter infection were similar in both groups. The incidence of catheter-related infection (including catheter-related sepsis, and bacteremia) was not different between the two groups (axillary vein: 8.1%; internal jugular vein: 7.6%). Catheter-related bacteremia were seen at a rate of 3.7% in the internal jugular vein group and a rate of 1.6% in the axillary vein group (NS). The incidence of catheter colonization was similar in both groups (axillary vein: 14.5%; internal jugular vein: 11.4%).
Catheter-related infection after axillary vein catheterization was similar to that observed after internal jugular vein catheterization. The chance of developing catheter-related sepsis was less than 10% with either route when catheters were used for the treatment of severely ill patients.
本研究旨在确定腋静脉插管后感染并发症的发生率，并与颈内静脉插管后的情况进行比较。
开展一项前瞻性比较开放性研究，以确定与经腋静脉或颈内静脉插入导管相关的感染并发症发生率。在研究期间，对所有接受中心静脉插管的患者进行评估。共有141例患者进入并完成了研究。导管插入部位为腋窝穿刺的腋静脉或前路穿刺的颈内静脉。采用定量技术对导管尖端进行培养。前瞻性收集与分析相关的临床信息。
共研究了141例患者的141根导管。两组患者导管感染的临床特征和危险因素相似。两组导管相关感染（包括导管相关脓毒症和菌血症）的发生率无差异（腋静脉：8.1%；颈内静脉：7.6%）。颈内静脉组导管相关菌血症发生率为3.7%，腋静脉组为1.6%（无统计学差异）。两组导管定植发生率相似（腋静脉：14.5%；颈内静脉：11.4%）。
腋静脉插管后导管相关感染与颈内静脉插管后相似。当导管用于治疗重症患者时，两种途径发生导管相关脓毒症的几率均小于10%。
