| 摘要 |
Total parenteral nutrition is commonly given through subclavian route. However, in fear of serious complication associated with subclavian vein puncture some physicians stayed away from using subclavian vein cath-eter. Jugular vein catheter and femoral vein catheters were used by some of the physicians for parenteral nutrition instead. The aim of this study is to evaluate (I) the incidence of catheter sepsis (2) the influence of catheter site and catheter type on catheter sepsis in patients receiving parenteral nutrition. From January 1993 to December 1994, 548 patients received paren- teral nutrition at Mackay Memorial Hospital, 299 catheters were instituted at subclavian, 209 catheters jugular and 40 catheters femoral sites. Catheter related sepsis was highest in femoral vein (15%), followed by jugular vein (4.78%). Subclavian vein had lowest catheter sepsis rate of 2%. Besides, triple lumen catheter had higher risk of catheter sepsis than single lumen catheter (14% vs. 3.6%). From this series, we believe that single lumen catheter via subclavian route is still the preferred route for total parenteral nutrition. Femoral vein catheter is accordingly unacceptable for infusing parenteral nutrition, especially when triple lumen catheter is to be used, because of high incidence of catheter related sepsis. Internal jugular vein catheter has higher infection rate than subclavian catheter and is more dif-ficult to apply occlusive dressing, and therefore, is not recommended as the route of first choice. |
