晚期胃癌患者不同肠外营养输注方式的应用与选择  

Application and choice of different intravenous infusion methods for parenteral nutrition in patients with advanced gastric cancer

作　　者：李疆[1] 秦苇[2] 孙彩霞[1] 

机构地区：[1]温州医科大学附属第一医院胃肠外科,温州325000 [2]温州医科大学附属第一医院风湿免疫科,温州325000

出　　处：《中华现代护理杂志》2017年第11期1478-1481,共4页Chinese Journal of Modern Nursing

基　　金：江苏省科技项目（BE2015624）

摘　　要：目的 评价浅静脉留置针、深静脉置管、PICC 3种不同静脉输液途径在晚期胃癌患者中进行肠外营养的效果.方法 将180例应用胃肠外营养的患者分为一次性静脉留置针输液组、深静脉置管组（CVC组）和PICC组,通过观察3组置管成功率、留置时间、静脉炎等置管并发症发生情况,评价三者的优缺点.结果 3种静脉穿刺置管方式、置管时间各不相同,其中PICC组所需置管时间最长;虽然3组患者在并发症发生率上差异并没有统计学意义（P〉0.05）,但CVC组和PICC组患者发生静脉炎较留置针组明显减少,且其他并发症情况也明显少于留置针组.结论 在胃肠外营养中,采用一次性静脉留置针输注途径相较于其他两种途径存在静脉炎发生率高、留置时间短的缺点;CVC置管途径虽存在深静脉血栓及感染的风险,但具有留置时间较长、静脉炎发生率低等优点;而PICC置管途径尽管费用较高,但留置时间长,静脉炎发生率低,适用于长期静脉输液的患者.Objective To evaluate the effects of three intravenous infusion modes （disposable venous indwelling needle, central venous catheter, and peripherally inserted central catheter） in patients with advanced gastric cancer for parenteral nutrition .Methods A total of 180 patients with parenteral alimentation were divided into three groups. Patients in group A were disposable venous indwelling needle, but patients in group B with central venous catheterization （CVC catheterization） and patients in group C with peripherally inserted central catheter （PICC transfusion）. Merits and demerits were evaluated in three groups via observing the index of cannula success rate, phlebophlogosis, indwelling time, etc. Results Average indwelling time of three intravenous infusion modes were not identical, and the group PICC catheter time was the longest; although there was no statistical difference in complication incidences （P〉0.05）, but the group of CVC and PICC patients with phlebitis situation were better than that of indwelling needle group, and complications were also less than needle group. Conclusions High occurrence rate of phlebophlogosis exists in using disposable venous indwelling needle, which leads to short indwelling time. Risks of deep venous thrombos and infection may happen with the CVC, while come with the longer indwelling time and lower occurrence rate of the phlebophlogosis as well. PICC cost higher, while come with the longer indwelling time and lower occurrence rate of phlebophlogosis. It is suitable for the patients with long-term venous transfusion.

关 键 词：胃肠外营养 胃肿瘤 静脉输液 

分 类 号：R473.73[医药卫生—护理学]