探討動脈導管手術前不同的皮膚準備方式於穿刺部位術後感染率之影響

A Study Investigating the Influence of Different Skin Preparation Methods before Arterial Catheterization on Postoperative Infection Rate of Puncture Site

蔡雪雅(Tsai, Hsueh-Ya)

指導教授 ： 黃正宜 ； 廖玟君

中山醫學大學/醫學院/護理研究所/碩士(2017年)

摘要

動脈導管檢查是常見的診斷心血管疾病的方法，而動脈導管術前的薙除毛髮是皮膚準備的一項常規。本研究目的在比較診斷性或治療性股動脈導管穿刺手術病人，術前接受使用2% chlorhexidine消毒液與接受剃薙之不同皮膚準備方式，對穿刺部位術後感染率之差異。本研究採前瞻性隨機分配設計，共78位病人，在股動脈導管術前實驗組採2% chlorhexidine消毒液，控制組採傳統的剃薙方式進行皮膚準備。研究主要結果是觀察導管術後30天內的手術部位感染率，次要結果是舒適度。研究結果發現在2% chlorhexidine消毒液組，皮膚表層之細菌菌落的數量顯著低於剃薙組（5.1％對89.7％; P = 0.000）。其次，2% chlorhexidine消毒液組在第1天（P = 0.041），第7天（P = 0.000）和第30天（P = 0.000）的舒適度顯著優於剃薙組。結論: 為手術前的皮膚準備使用2% chlorhexidine消毒液優於剃薙，能有效防止動脈導管術後的傷口感染。

關鍵字

導管檢查 ； 皮膚準備 ； 感染率 ； 舒適度

並列摘要

Arterial catheterization is a common method for diagnosis of cardiovascular diseases. Routine hair removal from a patient before catheterization has been a part of preparation for decades.The purpose of this study is to compare the efficacy of 2% chlorhexidine versus skin shaving preparation in the prevention of surgical site infections in diagnostic or therapeutic femoral artery catheterization.This was a prospective randomized controlled trial. A total of 78 patients were randomized into two groups in one hospital; 2% chlorhexidine and shaving skin preparation before femoral artery catheterization. The primary outcome was any surgical site infection within 30 days after catheterization. Secondary outcomes included comfort level.The numbers of bacterial colonies was significantly lower in the 2% chlorhexidine group than in the shaving group (5.1% vs. 89.7%; P = 0.000).The comfort level in the 2% chlorhexidine group was significantly less pain than shaving group in day1 (P=0.041), day7(P = 0.000) and day 30 (P = 0.000).Preoperative preparation of the patient’s skin with 2% chlorhexidine is superior to preparation with shaving for preventing surgical-site infection after catheterization.

並列關鍵字

Catheterization Examination ； Skin Preparation ； Infection Rate ； Comfort

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