血液肿瘤患者PICC置管静脉与导管直径最佳比例的研究  

Optimal proportion between peripherally inserted central catheter vein and catheter among hematologic tumor patients

作　　者：戚晓梅[1] 丁新红 任国琴[2] 华红霞[3] 曹琪 Qi Xiaomei;Ding Xinhong;Ren Guoqin;Hua Hongxia;Cao Qi(Department of Hematology, Wuxi Second People's Hospital of Nanjing Medical University Wuxi 214002,China;Nursing Department, Wuxi Second Peoples Hospital of Nanjing Medical University, Wuxi 214002,China;Department of Oncology, Wuxi Second People's Hospital of Nanjing Medical University, Wuxi 214002,China)

机构地区：[1]南京医科大学附属无锡二院血液科,214002 [2]南京医科大学附属无锡二院护理部,214002 [3]南京医科大学附属无锡二院肿瘤科,214002

出　　处：《中华现代护理杂志》2019年第6期720-722,共3页Chinese Journal of Modern Nursing

基　　金：无锡市卫生计生委科技成果与适宜技术项目(T201703).

摘　　要：目的探讨PICC 置管静脉与导管直径比例对血液肿瘤患者置管术后出血、堵管的影响。方法选择2016年2月—2018年2月南京医科大学附属无锡二院血液科收治患者105例作为研究对象。 PICC 置管前,预先采用便携式彩色多普勒超声系统测量所选静脉直径,获取置入静脉与导管直径比值。 105例血液肿瘤患者PICC置管后,置管静脉/导管直径<2、2~3、>3纳入样本量均为35例。观察不同比例置管后患者出血、堵管发生率。结果 3组血液肿瘤患者在置管后出血量差异均无统计学意义(P> 0.05);堵管发生率比较差异有统计学意义(P< 0.05)。结论血液肿瘤患者PICC 置管后出血、导管堵塞高发生率不容忽视,置管静脉/导管直径对置管后出血无明显影响,但可以影响导管堵塞发生率。因此,临床中,应使用可视化评估工具准确测量患者穿刺静脉内径,选择合适的导管来降低置管术后并发症。Objective To explore the proportion between peripherally inserted central catheter (PICC) vein and catheter on hemorrhage and plugging among hematologic tumor patients. Methods From February 2016 to February 2018, we selected 105 patients of department of hematology in Wuxi Second People's Hospital of Nanjing Medical University as subjects. Before PICC, vein diameter was measured with the portable color doppler ultrasound system to obtain the proportion between catheterization vein and catheter diameter. Among 105 PICC catheterization cases of hematologic tumor patients, proportions between catheterization vein and catheter diameter were divided into three groups including < 2,2 to 3,> 3,35 cases in each group. We observed the incidences of hemorrhage and plugging at different proportions of catheterization. Results There was no statistical difference in the amount of bleeding of hematologic tumor patients among three groups after catheter( P>0.05). There was a statistical difference in the incidence of plugging( P<0.05). Conclusions The incidence of hemorrhage and plugging of hematologic tumor patients after PICC cannot be ignored. The proportion between catheterization vein and catheter diameter has no obvious effect on hemorrhage after catheter, but it can affect the incidence of catheter plugging. Therefore, we should apply visual assessment instrument to exactly measure the internal diameter of vein and select appropriate catheter to reduce the complications after catheterization.

关 键 词：血液肿瘤 出血 PICC 静脉/导管直径 导管堵塞 

分 类 号：R473.73[医药卫生—护理学]