基层医院肿瘤患者化疗时护士中心静脉置管途径选择  

Primary Hospital Cancer Patients Chemotherapy Nurse Central Venous Catheter Pathway Selection

作　　者：蒋维芬 罗丽萍[1] 唐敏[1] 龚天平[1] 

机构地区：[1]四川省安岳县人民医院肿瘤科,四川安岳642350

出　　处：《中国医药指南》2013年第31期317-318,共2页Guide of China Medicine

摘　　要：目的探讨基层医院肿瘤患者化疗时中心静脉置管导管及途径的选择。方法124例恶性肿瘤患者被随机分为观察组和对照组各62例；观察组选择经外周静脉穿刺中心静脉置管（PICC），对照组选择在B超引导下颈内静脉置管，同时观察两组在化疗过程的应用效果。分别统计两组的一次性置管成功率、导管相关并发症发生率，导管留置时间为10天、10～30d、30～60d、60d以上。结果观察组置管一次性成功率为98％，并发症发生率6.4％，留置60d以上60例；对照组一次性成功率为92％，并发症发生率29％，留置60d以上的4例；两组在疗效分布上的差异无统计学意义（P〈0．05）。结论基层医院对肿瘤化疗患者进行静脉置管时要先对患者情况进行综合评估以选择合适的置管方式。PICC和B超引导颈内静脉置管是恶性肿瘤静脉输液的理想方式（条件允许推荐使用PICC置管），在保护患者血管、保证化疗质量上优势显著，值得在基层医院推广。Objective To investigate venous catheterization selecting for cancer patients with chemotherapy in basic level hospitals. Methods 124 patients with malignant tumor were randomly and evenly divided into two groups： the observation group and control group. Peripherally inserted central catheter （PICC） was used for the observation group. Ultrasound-gnided catheterization of internal jugular vein was used for the control group. The effect of catheterization, the vein puncture success rate and the complication rate Of the two groups were observed. The catheters were retained for 10 days, 10-30 days, 30-60 days, 60 days or more.Results The observation group＇s success rate was 98%, complication rate was 6.4%. And there are 60 cases whose catheters were retained for more than 60 days in this group. The control group＇s success rate was 92%, complication rate was 29%. And there are just 4 cases whose catheters were retained for more than 60 days in this group. There was no significant difference of curative effect between the two groups（P〈0.05）. Conclusion For basic level hospitals, we can select appropriate ways of venous catheterization for the cancer patients with chemotherapy only after assessments of their conditions. PICC and ultrasound-guided catheterization of internal jugular vein aretwo ideal ways of intravenous infusions for cancer patients with chemotherapy （PICC is preferred if it is possible）, they have significant advantages of protecting blood vessel and assuring the quality of chemotherapy, and they are worth popularizing in basic level hospitals.

关 键 词：基层医院 肿瘤化疗患者 护士 中心静脉置管 

分 类 号：R472[医药卫生—护理学]