某醫學中心周邊靜脈導管靜脈炎發生情形及其實證應用之世代研究

A Cohort Study on the Incidence Rate of Peripheral Venous Catheter-Related Phlebitis and Its EBM Applications in a Teaching Hospital

10.29827/YBYJZZ.202209_6(1).0003

黃秀英(Hsiu-Ying Huang)；楊麗瓊(Li-Chiung Yang)；黃惠美(Huang Hui Mei)；闕靜儀(Ching-Yi Chueh)；林小玲(Shirling Lin)；吳聖良(Shang-Liang Wu)

靜脈炎 ； 發生率 ； 發生密度 ； 世代研究 ； 實證研究 ； Peripheral Venous Catheter-Related Phlebitis ； Incidence ； Incidence rate ； Cohort study ； Evidence-based research

醫保研究雜誌

6卷1期（2022 / 09 / 01）

25 - 34

繁體中文

目的：比較72小時與96小時更換周邊靜脈導管靜脈炎發生密度並計算其風險比值（Hazard Ratios；HR），以作為推動實證研究之參考。方法：採前瞻世代研究（Prospective cohort study）設計，期間為2018年9月15日至2018年12月30日，在某醫學中心9個內科病房以立意取樣收案，總得樣本203人，其中72小時與96小時更換周邊靜脈導管者分別為110人與93人；追蹤時間為7天內，以Cox regression比較兩組間靜脈炎發生密度並計算其風險比值（Hazard Ratios；HR）及95%信賴區間（Confidence interval, CI）。結果：兩組間10個混淆因素中之性別、置針地點、導管尺寸、置針皮膚周圍狀況與注射刺激性藥物等5個混淆因素未達顯著差異；年齡、疾病診斷、置針部位、輸液含氯化鉀濃度及間歇分離導管（用注射帽封蓋）的頻次等5個混淆因素達顯著差異。無論有否調整混淆因素，兩組間之靜脈炎發生密度未達顯著差異；203位樣本之周邊靜脈導管者靜脈炎發生密度為13.1%（即每人天之靜脈炎人數達13.1人；93位靜脈炎者之平均發生時間為2.1±1.0天，最短0.4天，最長6.1天）。結論：72小時與96小時更換周邊靜脈導管之靜脈炎發生密度未達顯著差異，建議比較臨床效果指標時，採用發生密度較為合理。

Purpose. To compare the incidence rates of peripheral venous catheter-related phlebitis between 72- and 96- hour insertions for inpatients. Methods. A prospective cohort design from Sep. 15^(th) to Dec.30^(th), 2018 of two-group (72-and 96-hour)with total 203 inpatients (110 and 93each) in nine medical wards were recruited. Each patient were follow-up within 7 days and the incidence rates were compared by Cox regression with hazard ratios (HR) and its 95% confidence interval (CI). Results. Out of 10 confounders, there were 5 of them (e.g. sex, injection locations, cannula size, skin situations around injection locations and injection medicines) reached significant difference between two groups. There were no significant difference between two groups in terms of incidence rates; overall incidence rate reached 13.1% (indicate 13.1 phlebitis per person-day; average time of incidence 2.1±1.0 days, minimum 0.4 days, maximum 6.1 days for 93 phlebitis patients). Conclusion. No significant difference between incidence rates of peripheral venous catheter-related phlebitis between 72- and 96- hour insertions for inpatients. It is more accurate to compare clinical outcome by using incidence rate.