恶性肿瘤患者应用PICC和CVC置管的临床观察与护理

Clinical Observation of Applying PICC and CVC in Patients with Malignant Tumor

目的 通过比较外周导入中心静脉置管 (penipherallyinsertedcentralcatheterPICC)与传统的经锁骨上或下静脉置管 (centralvenouscatheterCVC)两种方法优劣 ,为今后的工作提供参考。方法 对PICC和CVC各 6 6例肿瘤患者进行临床研究。结果 PICC置管成功率为 95 .45 % ,CVC置管成功率为87.78%。二组无明显差异 (P >0 .0 5 )。导管阻塞发生率 ,PICC组为 10 .6 1% ,CVC组为 15 .15 % ;PICC组静脉炎发生率为 15 .15 %而CVC组局部感染率为 7.5 8% ,导管脱落发生率为 3.0 % ,气胸发生率为7.5 8%误入动脉发生率为 4.5 5 %。结论 两种导管成功率和一般并发症发生率无差异 ,但严重的并发症具有显著差异 ,对PICC具有损伤小 ,定位准确 ,易操作、病人满意 ,又可避免严重气胸或误入动脉的并发症 ,适用于肿瘤患者的长期接受化疗药物 ,肠外营养及抗菌素等治疗 ,有利患者康复 ,具有临床应用价值。

Objective To provide a better central venous catheter inserting method though comparing peripherally inserting central catheter (PICC) with traditional central venous catheterization (CVC). Methods Clinical study was done in 66 cases of malignant tumor patients applying PICC and 66 cases applying CVC. Results The successful rates of PICC and CVC were 95.45%, 87.78%, there was no significant difference, P>0.05. The blocking rates were 10.61% and 15.15% ; the incidence of phlebitis in PICC group was 15.15% . In CVC group, local infection rate was 7.58%, catheter exfloliation was 3.0%, incidence of pneumatothorax was 7.58%, inserting into arterial by error was 4.55%. Conclusions Successful rates and complication incidence of two methods are same. But the serious complications occur in CVC group, PICC has some features as follow: light injury, accurate location and easy operation. It is adapted to tumor patients, who accept chemotherapy parenteral nutriment and antibiotic therapy for long time.