肿瘤患者耐高压注射型经外周静脉置入中心静脉导管堵管风险因素的调查分析  

Survey on the Risk Factors of High Pressure Resistant Peripherally Inserted Central Catheter Blockage among Tumor Patients

作　　者：张蕾 李英华 莫晓晨 杨青敏 ZHANG Lei;LI Yinghua;MO Xiaochen;YANG Qingmin(Department of Nursing,Minhang Branch of Tumor Hospital,Fudan University,Shanghai 200240,China;Central Laboratory,Shanghai Fifth People’s Hospital,Fudan University,Shanghai 200240,China;Radiotherapy Department,Minhang Branch of Tumor Hospital,Fudan University;Department of Nursing,Shanghai Fifth People’s Hospital,Fudan University)

机构地区：[1]复旦大学附属肿瘤医院闵行分院护理部,上海200240 [2]复旦大学附属上海市第五人民医院中心实验室,上海200240 [3]复旦大学附属肿瘤医院闵行分院放疗科 [4]复旦大学附属上海市第五人民医院护理部

出　　处：《解放军护理杂志》2021年第1期75-79,共5页Nursing Journal of Chinese People's Liberation Army

基　　金：上海市闵行区卫生健康委员会科研课题(2019MW15);上海市闵行区社会科学研究课题(G20114)。

摘　　要：目的了解肿瘤患者住院期间耐高压注射型经外周静脉置入中心静脉导管(peripherally inserted central catheter,PICC)置管发生堵管的风险因素,为相关护理提供理论指导。方法便利抽样选取某院288例携带耐高压注射型PICC肿瘤患者,分析其住院期间PICC导管堵塞发生的影响因素。结果留置耐高压注射型PICC住院肿瘤患者住院期间发生堵管率为29.9%,年龄、体质量指数(body mass index,BMI)、D2聚体对堵管发生率影响显著。和<45岁相比,年龄45~60岁和>60岁时堵管发生率的OR值分别为4.892(P=0.056)和11.286(P<0.001);BMI≥24时堵管发生率的OR值为4.831(P=0.002);使用碘对比剂患者堵管发生率的OR值为0.079(P<0.001),碘对比剂的使用是堵管发生的保护因素。结论需特别关注年龄>45岁、BMI≥24以及未使用碘对比剂的携带耐高压注射型PICC肿瘤患者,并积极采取预防堵管发生的护理措施。Objective To investigate the risk factors of high pressure resistant peripherally inserted central catheter(PICC)blockage among tumor patients during hospitalization,so as to provide theoretical guidance for relevant nursing.Methods Convenient sampling was used to select 288 tumor patients with high pressure resistant PICC from a hospital to analyze the influencing factors of PICC blockage during their hospitalization.Results The blockage rate among the tumor patients with high pressure resistant PICC during their hospitalization was 29.9%.Age,body mass index(BMI),and D-Dimer exerted significant effects on the blockage rate.Compared with patients younger than 45-year-old,the OR values of the blockage rate were 4.892 for the patients aged between 45 and 60 years old(P=0.056),and 11.286 for the patients older than 60-year-old(P<0.001).When BMI≥24,the OR value of the blockage rate was 4.831(P=0.002).The OR value of the blockage rate among patients using iodine contrast agent was 0.079(P<0.001).The use of iodine contrast agent was a protective factor for the occurrence of blockage.Conclusions Special attention should be paid to the tumor patients with high pressure resistant PICC who are older than 45-year-old,and with the BMI≥24 and have not used the iodine contrast agent.Preventive nursing measures should be taken positively to reduce the blockage rate.

关 键 词：肿瘤 耐高压注射型 经外周静脉置入中心静脉导管 堵管 

分 类 号：R473.73[医药卫生—护理学]