微量肝素钠持续冲洗PICC导管预防堵管的效果观察  

The effect of continuous flushing PICC with minim-heparin sodium for prophylaxis of occlusion

作　　者：邓玉英[1] 黄辉文[1] 杨海斌[1] 邝文英[1] 郭碧清[1] 郭梁[1] 邓宜雅[1] 

机构地区：[1]珠海市妇幼保健院新生儿科,广东珠海519000

出　　处：《临床和实验医学杂志》2009年第7期81-82,共2页Journal of Clinical and Experimental Medicine

摘　　要：目的探索预防外周置入中心静脉导管(PICC)导管堵塞的有效方法,分析导管堵塞因素及防护措施。方法将2005年6月至2009年5月78例PICC置管分为对照组和实验组,其中2005年6月至2008年3月22例作为对照组和2008年4月至2009年5月56例作为实验组。对照组用生理盐水每4h冲管一次,每日7:00用肝素钠生理盐水2ml10U冲管一次。实验组用微量肝素钠0.5U/ml持续冲洗PICC导管,2～3ml/h维持,在使用乳剂或组间存在配伍禁忌时,用生理盐水2ml冲管一次。结果对照组导管部分堵塞及全部堵塞的发生率为54.54%,实验组为19.64%,两组比较差异具有显著性。对照组发生部分堵塞6例,发生率为50%,因严重堵塞而拔管的有6例,发生率为50%,实验组发生部分堵塞5例,发生率为45.45%,发生完全堵塞6例,发生率为54.54%,无静脉血栓的发生。结论微量肝素钠持续冲洗PICC导管较传统的生理盐水或肝素钠间断冲洗预防堵管更为有效,方便,值得推广。Objective To explore the available way for preventing occlusion of PICC and analyze causes forocclusion. Methods There were 78 neonates involved, 22 patients were in control group during June 2005 to March 2008, and 56 babies were in trial group from April 2008 to May 2009. Two methods for prophylaxis of occlusion were used ： the conventional way was flushing PICC with normal saline 6 times and heparin sodium（ 10 U） once at 7：00 every day, and in trial group flushing PICC with heparin sodium （0.5 U/ml） continually for 24 hours maintaining at 2 - 3 ml/h, occasionally flushing PICC by normal saline （2 ml）, when emulsion or various drugs could not mix up. Results In control group, occlusion of PICC occurred in 54.54% of cases and it only happened in 19.64% cases of trial group with minim - heparin sodium flushing. In control group, partial occlusion of PICC occurred in 6 patients and PICC of 6 babies were pulled out in 6 babies due to entire occlusion. Partial occlusion occurred in 5 patients and entire occlusion without thrombosis occurred in 6 patients. Conclusion Flushing PICC with minim - heparin sodium is a more effective and convenient method, and it is worthy to be recommended for application.

关 键 词：外周置入中心静脉导管(PICC) 并发症 肝素钠 

分 类 号：R472[医药卫生—护理学]