经外周静脉置入中心静脉导管与超声引导下置管对置管感染影响的临床研究  

Clinical study on influence of peripherally inserted central venous catheter and ultrasound-guided catheterization on early infections

作　　者：姜敏[1] 张帆[1] 李红[1] 

机构地区：[1]齐齐哈尔医学院附属第三医院科研科,黑龙江齐齐哈尔161000

出　　处：《中华医院感染学杂志》2015年第9期2023-2024,2027,共3页Chinese Journal of Nosocomiology

基　　金：黑龙江省卫生厅中青年科技优先基金资助项目(101728)

摘　　要：目的分析比较乳腺癌患者术后化疗传统经外周静脉置入中心静脉导管(PICC)与超声引导下置管对早期感染的影响,为临床治疗提供参考。方法选取2011年1月-2013年12月乳腺癌术后进行化疗患者200例,随机分为观察组和对照组,各100例,所有患者在手术后均接受内置管化疗;观察组采用超声引导下置管,对照组采用传统PICC,对比两组患者置管一次性成功率及总成功率、静脉炎发生率、早期感染率。结果观察组一次性置管成功率74.0%、总成功率91.0%,对照组分别为43.0%和69.0%,观察组一次成功率和总成功率均明显高于对照组,两组比较差异有统计学意义(P<0.05);观察组静脉炎发生率为4.0%,对照组为15.0%,两组比较差异有统计学意义(P<0.05);观察组前3周创口感染率为1.0%,对照组为8.0%,两组比较差异有统计学意义(P<0.05)。结论乳腺癌患者术后化疗应用超声引导下置管一次性置管成功率高,静脉炎发生率及早期感染率低,有利于提高患者的生活质量,有极高的诊断价值和广阔的临床应用前景。OBJECTIVE To observe the influence of the peripherally inserted central venous catheter （PICC） and ul‐trasound‐guided catheterization on the early infections in breast caner patients after chemotherapy so as to provide guidance for the clinical treatment .METHODS A total of 200 breast cancer patients who underwent chemotherapy from Jan 2011 to Dec 2013 were enrolled in the study and randomly divided into the observation group and the con‐trol group ,with 100 cases in each ,all the patients received the catheter chemotherapy after surgeries;the obser‐vation group was treated with ultrasound‐guided catheterization ,and the control group was given the conventional PICC .The one‐time success rate of catheterization ,total success rate ,incidence of phlebitis ,and incidence of early infections were observed and compared between the two groups .RESULTS The one‐time success rate of catheter‐ization was 74 .0% in the observation group ,significantly higher than 43 .0% in the control group;the total suc‐cess rate was 91 .0% in the observation group ,significantly higher than 69 .0% in the control group（P〈0 .05） . The incidence of phlebitis was 4 .0% in the observation group ,15 .0% in the control group ,with statistical signifi‐cance （P〈0 .05）;the incidence of wound infections was 1 .0% in the observation group within three weeks , 8 .0% in the control group , and there was significant difference between the two groups （ P〈0 .05 ） . CONCLUSION The one‐time success rate of ultrasound‐guided catheterization is high for the breast cancer patients undergoing postoperative chemotherapy ,the incidence of phlebitis and early infections is low ,and it may improve the quality of life of the patients and has tremendous diagnostic value and broad prospect for clinical application .

关 键 词：乳腺癌 化疗 中心静脉置管 超声 感染 

分 类 号：R181.32[医药卫生—流行病学]