基于超声辅助的血管分级管理在治疗性单采患者中的应用效果分析  

Analysis of the application effect of ultrasound-assisted vascular classification management in therapeutic apheresis patients

作　　者：石洁 许志强 陆婧媛[1] 林玉凤 蔡志云[2] SHI Jie;XU Zhiqiang;LU Jingyuan;LIN Yufeng;CAI Zhiyun(Zhongshan Hospital of Xiamen University,Department of Hematology,Xiamen,Fujian 361004,China;Zhongshan Hospital of Xiamen University,Venous Therapy Specialist Clinic,Xiamen,Fujian 361004,China)

机构地区：[1]厦门大学附属中山医院血液科,福建厦门361004 [2]厦门大学附属中山医院静脉治疗专科门诊,福建厦门361004

出　　处：《现代医药卫生》2024年第18期3132-3136,共5页Journal of Modern Medicine & Health

基　　金：福建省厦门市科技局科学自然基金项目(3502Z20227100);苏州协同医疗健康基金会全国肺栓塞与深静脉血栓形成防治能力建设项目(Y035)。

摘　　要：目的 探讨基于超声辅助的血管分级管理在治疗性单采(TA)患者中的应用效果。方法 选取2019年1月至2023年11月在厦门市某三甲医院血液科行TA的174例患者为研究对象,根据治疗时间分为观察组(2022年1月至2023年11月)和对照组(2019年1月至2021年12月),各87例。对照组患者由TA团队根据个人经验置入静脉通路,观察组患者则基于B超辅助进行血管分级管理。比较2组患者在一次性穿刺成功率、中心静脉导管(CVC)使用率、静脉导管并发症、采集相关不良反应及静脉导管费用、患者满意度方面的差异。结果 2组患者均完成TA,观察组患者一次性穿刺成功率为93.1%,高于对照组的81.6%,差异有统计学意义(P<0.05)。观察组患者CVC插管率及费用低于对照组,患者满意度高于对照组,差异均有统计学意义(P<0.05)。2组患者静脉导管并发症均与CVC有关,但发生率比较,差异无统计学意义(P>0.05)。结论 基于超声辅助的血管分级管理能提高TA患者一次性置管成功率及患者满意度,减少TA患者的CVC插管率及插管费用。Objective To explore the application effect of ultrasound-assisted vascular classification management in therapeutic apheresis(TA)patients.Methods A total of 174 patients undergoing TA in the Department of Hematology of a tertiary hospital in Xiamen from January 2019 to November 2023 were selected as the study subjects.According to the treatment time,they were divided into an observation group(January 2022 to November 2023)and a control group(January 2019 to December 2021),with 87 patients in each group.The control group had venous access placed by the TA team based on personal experience,while the observation group underwent vascular classification management assisted by B-mode ultrasound.The differences between the two groups were compared in terms of one-time puncture success rate,central venous catheter(CVC)usage rate,venous catheter complications,apheresis-related adverse reactions,venous catheter costs,and patient satisfaction.Results Both groups completed the TA.The one-time puncture success rate in the observation group was 93.1%,which was significantly higher than the 81.6%in the control group(P<0.05).The CVC insertion rate and associated costs in the observation group were lower than those in the control group,and patient satisfaction in the observation group was higher than that in the control group,with statistically significant differences(P<0.05).Venous catheter complications in both groups were related to CVC,but there was no statistically significant difference in the incidence rate(P>0.05).Conclusion Ultrasound-assisted vascular classification management can improve the one-time catheterization success rate and patient satisfaction in TA patients,while reducing the CVC insertion rate and associated costs.

关 键 词：超声 辅助 外周血管装置 血管分级管理 治疗性单采 中心静脉导管 

分 类 号：R473[医药卫生—护理学]