标准化PICC操作技术提高肠外营养输注安全的对照研究  

Whole-course standardized peripherally inserted central catheter implantation improves the safety of parenteral nutrition infusion:a case-control study

作　　者：李磊[1] 刘鹏[1] 杨晓燕[1] 李欣[1] 崔红元[1] 宋京海[1] 朱明炜[1] Li Lei;Liu Peng;Yang Xiaoyan;Li Xin;Cui Hongyuan;Song Jinghai;Zhu Mingwei(Department of General Surgery,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院普外科,国家老年医学中心,中国医学科学院老年医学研究院,100730

出　　处：《中华临床营养杂志》2023年第4期204-207,共4页Chinese Journal of Clinical Nutrition

基　　金：中国医学科学院临床研究基金(2021-I2M-C&T-B-094);中国食品科学技术学会食品科技基金(2020-14)。

摘　　要：目的评价标准化经外周静脉置入中心静脉导管(peripherally inserted central catheter,PICC)操作系列技术在肠外营养输注途径管理中的临床价值。方法共纳入943例患者,分为研究组(457例)和对照组(486例),研究组应用标准化PICC操作系列技术完成以肠外营养输注,对照组选择肘下穿刺在超声引导或直接穿刺,对比观察PICC穿刺成功率、导管留置时间、并发症发生率、患者满意度等。结果两组患者穿刺总成功率均为100%,其中研究组一针成功率(92.6%比72.2%,xˉ=66.229,P<0.001)和导管留置时间[(25.4±2.3)d比(21.6±3.1)d,t=21.271,P<0.001)均高于对照组。研究组近期并发症发生率显著低于对照组(3.50%比11.52%,xˉ=21.490,P<0.001)。结论建立并执行PICC标准化操作规范是提高肠外营养输注途径管理质量的有效方法。Objective To evaluate the clinical effectiveness of the standardized peripherally inserted central catheter(PICC)implantation procedure in the management of parenteral nutrition infusion routes.Methods Patients were enrolled from January 2018 to January 2020 and were divided into the study and control groups,receiving standard operating procedures of PICC or insertion through below elbow with or without ultrasonic guidance.The differences in the success rate of PICC insertion,catheter indwelling time,incidence rate of complications,and patient satisfaction were compared.Results A total of 943 subjects were included.The study group and the control group were comparable in terms of baseline characteristics such as disease type,body mass index and prevalence of nutritional risk.The overall success rate was 100%in both groups.The first-attempt success rate in the study group was higher compared with the control group(92.6%vs 72.2%,χ^(2)=66.229,P<0.001),and the catheter indwelling time was longer([25.4±2.3]d vs[21.6±3.1]d,t=21.271,P<0.001).The incidence rate of short-term complications in the study group was significantly lower than that in the control group(3.50%vs 11.52%,χ^(2)=21.490,P<0.001),while there was no significant difference in the incidence rate of long-term complications between the two groups(6.78%vs 8.85%,χ^(2)=1.388,P=0.239).Conclusion Establishing and implementing the standardized operating procedure of PICC is an effective method to improve the management of parenteral nutrition infusion routes.

关 键 词：经外周静脉置入中心静脉导管 肠外营养 导管相关感染并发症 

分 类 号：R472[医药卫生—护理学]