外周静脉留置针临床指征更换与常规置换安全性评价  

The safety of clinically indicated replacement or routine replacement of peripheral intravenous catheters:A Randomized Controlled Study

作　　者：杨勤玲[1] 鲁华鹏 冯爱芳[1] 孙亚利[1] 周晓玲[1] 张丽[1] 屈彦[1] 李娟利[1] 郭小叶[1] 杨亚丽[1] 焦健方[1] 谢娜 辛霞[1] 郑雪梅[1] YANG Qin-ling(Department of Hepatobiliary and Pancreas Surgery,The First Affiliated Hospital,Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院,陕西西安710061

出　　处：《牡丹江医学院学报》2020年第6期12-16,共5页Journal of Mudanjiang Medical University

基　　金：陕西省自然科学基金(2017SF-237);西安交通大学第一附属医院基金(2017HL-04)。

摘　　要：目的探究根据临床指征更换外周静脉留置针(peripheral intravenous catheters,PIVC)与每72~96 h更换一次PIVC临床安全性,为静脉治疗提供依据。方法选择某院10个护理单元2019年9月至10月间收治拟行PIVC静脉输液治疗的住院患者为研究对象,每护理单元收集60例数据,采用随机数字表法随机分为“临床指征组”与“常规更换组”,各30例,常规更换组PIVC留置96 h或96 h内出现临床症状拔除导管,临床指征组出现并发症时拔除导管。对比两组静脉炎、导管相关性感染、堵塞、渗出、任意形式输液失败发生率。结果临床指征组患者PIVC留置时间为(83.62±50.08)h,长于常规更换组PIVC留置时间(69.75±25.54)h,差异具有显著性(P=0.003)。临床指征组比常规更换组静脉炎(27.67%vs 13.66%,χ^2=17.932,P<0.001)、堵塞(15.33%vs 2.67%,χ^2=29.385,P<0.001)、渗出(6.66%vs 2.67%,χ^2=5.395,P=0.020)、任意形式输液失败(67.33%vs 31.67%,χ^2=76.334,P<0.001)发生率高,差异有统计学意义。绘制PIVC总体生存分析曲线,PIVC静脉输液中位生存期为59.58 h,48 h累计生存率77.00%,72 h累计生存率51.33%,96 h累计生存率20.33%。结论PIVC输液每72~96 h更换一次比根据临床指征更换安全。Objective To explore the safety of clinically indicated or every 96 hours for PIVC(peripheral intravenous catheters,PIVC)replacement intervals.Methods Ten nursing units in a hospital were selected from September to October 2019 to treat inpatients who were to be treated with PIVC intravenous infusion treatment as the research objects.Data of 60 cases were collected for each nursing unit and randomly divided into the"clinical indication group"using a random number table method"And"routine replacement group",30 cases each,routine replacement group PIVC indwelling 96 hours or clinical symptoms within 96 hours to remove the catheter,clinical indications group when complications occur.The incidence of phlebitis,catheter-related infection,blockage,exudation,and failure of any form of infusion were compared between the two groups.Results The indwelling time of PIVC in the clinical indication group was(83.62±50.08)h,which was longer than that in the routine replacement group(69.75±25.54)h.The difference was significant(P=0.003).Compared with the routine replacement group,the clinical indication group has phlebitis(27.67%vs 13.66%,χ^2=17.932,P<0.001),blockage(15.33%vs 2.67%,χ^2=29.385,P<0.001),exudation(6.66%vs 2.67%,χ^2=5.395,P=0.020),any form of infusion failure(67.33%vs 31.67%,χ^2=76.334,P<0.001)had a high incidence,and the difference was statistically significant.The overall survival analysis curve of PIVC was drawn.The median survival time of PIVC intravenous infusion was 59.58 h,the cumulative survival rate at 48 h was 77.00%,the cumulative survival rate at 72 h was 51.33%,and the cumulative survival rate at 96 h was 20.33%.Conclusion Replacement of PIV every 72~96 hours is safer than according to clinically indicated.

关 键 词：外周静脉留置针 留置时间 并发症 静脉炎 

分 类 号：R471[医药卫生—护理学]