PICC与VPA在消化道肿瘤术后化疗途径的应用对比研究  

Comparative study on the application of infusion route in patients with digestive tract tumor postoperative chemotherapy

作　　者：康小云[1] 郝楠[1] 张勇[1] 夏鹏 李小妹[2] KANG Xiaoyun;HAO Nan;ZHANG Yong;XIA Peng;LI Xiaomei(Department of Surgery Oncology, The First Affiliated Hospital,Xi′an Jiao Tong University, Xi′an 710061, China;College of Nursing, Xi′an Jiao Tong University, Xi′an 710061, China)

机构地区：[1]西安交通大学第一附属医院肿瘤外科,西安710061 [2]西安交通大学护理学系,西安710061

出　　处：《新疆医科大学学报》2018年第1期120-124,共5页Journal of Xinjiang Medical University

基　　金：国家自然科学基金面上项目(81372280)

摘　　要：目的比较消化道肿瘤术后化疗患者不同输液途径的并发症发生情况及其影响因素。方法选择2013年10月-2015年8月某三级甲等医院消化道肿瘤手术后化疗患者248例,分为外周静脉中心静脉置管组(PICC组)和植入式中心静脉输液港组(VPA组),分析2组患者置管过程中和置管后并发症发生的情况及其影响因素。结果 2组患者在置管部位、置管长度、置管过程中及置管后并发症方面差异具有统计学意义(P<0.001)。2组患者置管过程中并发症主要为穿刺失败,PICC组发生率为5.6%,VPA组发生率为4.0%。置管过程中并发症发生的危险因素包括深静脉置管方式、调管次数和穿刺次数(P<0.001)。置管后并发症发生的危险因素包括性别、置管方式和穿刺次数,男性较女性发生率高,VPA组较PICC组并发症少,穿刺次数越多并发症越多。结论VPA方式相比PICC方式更具临床安全性,是消化道肿瘤术后患者化疗的首选静脉通路。Objective To compare the factors of postoperative chemotherapy of digestive tract tumor in patients with complications caused by different ways of infusion.Methods248patients who received chemotherapy after gastrointestinal tumor surgery in a Top-three hospital in October2013-August2015were divided into peripheral central venous catheterization group(PICC group)and implantable central venous infusion group(VPA group).The incidence of complications and influencing factors in the two group patients during and after catheterization were to analyze.Results The differences between the2groups of patients in the site of catheter,length of catheter,catheter and process after catheter complications were statistically significant(P<0.001).Puncture failure was the main complication in the intubation process,that the incidence of PICC group was5.6%,whereas that of VPA group was4.0%.The risk factors of complication during catheterization included deep venous catheterization ways,the number of adjusting tube and the number of puncture(P<0.001).The risk factors of complication after catheterization included gender,catheterization way and the number of puncture,in which the incidence of males were higher than females,the complications of the VPA group were more than that of the PICC group,and the more punctures,the more complications.Conclusion The VPA method is safer than the PICC method in clinical,and it is the preferred intravenous route for patients with chemotherapy of postoperative digestive tract tumor.

关 键 词：消化道肿瘤 PICC VPA 化疗 并发症 

分 类 号：R473.73[医药卫生—护理学]