中心静脉导管插管在普外科静脉输液和营养支持患者中的应用管理  

The Clinical Application of Central Venous Catheter for General Surgical Patients

作　　者：李秀东[1] 罗萍[1] 林冰[1] 

机构地区：[1]广东省东莞市人民医院普外科,广东东莞523018

出　　处：《海南医学》2005年第8期28-29,共2页Hainan Medical Journal

摘　　要：目的探讨中心静脉导管插管在普外科创伤、恶性肿瘤晚期和慢性消耗性疾病中的应用价值及其管理。方法132例病人因补充有效循环血容量或长时间肠外营养支持的需要而接受了中心静脉置管,用心电图方法监测导管尖端位置,插入深度参考MadanM方法计算,严格插管过程中的规范操作,插管后进行严格的导管无菌管理。结果所有病人均顺利置管,插入深度及导管尖端位置适宜。128例病人于完成输液后拔除导管,其中2例怀疑导管败血症(catheterrelatedsepsis,CRS)的发热病人,经用0.1mol/L的NaOH冲洗腔及罗氏芬封管2天后,病人体温恢复正常后继续使用中心静脉导管;另外4例中,1例因使用不慎致导管破损而中途拔除,3例因发热怀疑CRS而中途拔除,其中2例诊断为临床CRS。结论正确的插管及管理方法有利于中心静脉导管的使用。Objective To investigate the value and administration of central venous catheter for surgical patients of trauma, terminal tumor and chronic wasting disease. Methods There were 132 cases of patients who had venous infusion through central venous catheter for restoration of effective circulating blood volume and long time parenteral alimentation. The location of catheter tip was monitored by electrocardiogram and the depth was calculated according to the formula of Madan M. The procedure was strict and correct, and so was sterility administration during infusion. Results The procedure was smooth and successful, and the depth was suitable. There were 128 cases who finished infusion, among which 2 cases experienced fever and infusion held up who recovered in 2 days by flushing with solution of sodium hydroxide and continued infusion through central venous catheter. There were still other 4 cases who had the catheter pulled out, one for breakage of catheter, and 3 for fever who were suspected as catheter related sepsis (CRS) and 2 were confirmed CRS clinically. Conclusions It is essential for clinical use of central venous catheter to intubate the catheter correctly and administer strictlyduring infusion by central venous catheter.

关 键 词：中心静脉导管 败血症 有效循环血容量 肠外营养 

分 类 号：R459.3[医药卫生—治疗学]