骨肿瘤化疗使用三腔瓣膜式外周静脉中心置管并发症原因分析  

The analysis related catheter complications cause of bone tumor chemotherapy using three cavity valve PICC pipe

作　　者：李燕燕[1] 杨明玉[1] 王媛[1] 

机构地区：[1]中国人民解放军总医院骨科,北京100853

出　　处：《中国肿瘤临床与康复》2014年第3期307-309,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨骨肿瘤化疗使用三腔瓣膜式外周静脉中心置管(PICC)导管相关性并发症特点及危险因素。方法选取2012年1月至2013年12月间收治的骨肿瘤并接受化疗使用三腔瓣膜式PICC管患者90例,发生并发症者24例设为试验组,无并发症者66例为对照组,分析两组特点和危险因素。结果相关并发症发生率为21.1%(19/90),其中穿刺点渗血发生率为6.7%(6/90),静脉炎发生率为4.4%(4/90),穿刺点感染率为3.3%(3/90),导管堵塞发生率为3.3%(3/90),血栓形成发生率为2.2%(2/90),导管脱出发生率为1.1%(1/90)。试验组患者年龄为(45.10±6.21)岁,高于对照组的(22.46±5.07)岁,差异有统计学意义(P<0.05);试验组的天气温度为(29.82±6.14)℃,高于对照组的(22.46±5.07)℃,差异有统计学意义(P<0.05);试验组患者置管时间为(304.08±31.26)d,高于对照组的(259.16±30.11)d,差异有统计学意义(P<0.05);试验组患者导管穿刺次数为(2.72±0.97)次,多于对照组的(1.48±0.82)次,差异有统计学意义(P<0.05);试验组患者机体免疫力低下比率为75.0%(18/24),高于对照组的67.1%(51/76),差异有统计学意义(P<0.05)。Logistic分析显示,年龄、平均天气温度、导管穿刺次数、置管时间和机体免疫力为PICC导管相关并发症的危险因素(P<0.05)。结论骨肿瘤化疗使用三腔瓣膜式PICC管导管相关性并发症是多因素综合所致,与患者年龄、天气温度、导管穿刺次数、置管时间和机体免疫力等因素有关,采取有效措施,可以降低并发症发生率。Objective To explore the causes of related catheter complications of three cavity valve PICC pipe on bone tumor chemotherapy. Methods 90 patients with bone tumor chemotherapy using three cavity valve PICC pipe were selected from January 2012 to December 2013 ,with 24 patients with complica- tions as the observation group, and 76 patients with no-complications as the control group. The relevant fac- tors and complications characteristics were analyzed. Results Related complication rate turned out to be 21.1% （19/90） ,including the rate of puncture site bleeding 6. 7% （6/90） , phlebitis incidence 4.4% （4/ 90）, the puncture point infection 3.3% （ 3/90）, catheter obstruction 3.3 % （3/90）, thrombosis 2. 2% （ 2/ 90） ,catheter ablationl. 1% （1/90）. The average age of observation group （45.10 ±6.21 ） was higher than that of the control group （ 22.46 ±5.07 ） years old （ P 〈 0. 05 ）. The average weather temperature of obser- vation group （29.82 ± 6. 14 ） ℃ was higher than that of the control group （22.46± 5.07 ） （ P 〈 0. 05 ） Mean catheterization time of observation group （ 304. 08±31.26） days was more longer than that of the control group （259. 16 ± 30. 11 ） （ P 〈 0. 05 ）. The average catheter puncture times of observation group （2. 72 ± 0. 97） times was more than that of the control group （ 1.48 ± 0. 82） times （ P 〈 0. 05 ）. The low immunity of observation group 75.0% （18/24） was more than that of control group 67.1% （51/76） ,the difference was statistically significant （P 〈 0. 05 ）. Logistic analysis showed that age, average temperatures, number of puncture, catheter indwelling time and immune function were independent risk factors of PICC catheter related complications （P 〈 0.05 ）. Conclusions The related complications of patients with bone tumor chemotherapy using three cavity valve PICC catheter are caused by multi factor comprehensively, such as age, average temperatures, number of puncture, catheter i

关 键 词：骨肿瘤 药物疗法 三腔瓣膜式PICC管 并发症 

分 类 号：R738.1[医药卫生—肿瘤]