中心静脉导管静脉内易位的临床分析

Clinical analysis on intravenous malposition of central venous catheters

目的分析、探讨中心静脉导管静脉内易位的原因、对临床的影响以及相应处理方法 和建议。方法对2004年1月至2010年2月发生中心静脉导管静脉内易位的12例患者进行回顾性分析,观察研究导管留置时间、输液效果、相关并发症、中心静脉压(CVP)测值以及患者的耐受性等。结果相对于正常置管位置,除导管栓塞发生率可能增加外,静脉内易位导管输液流量、感染等相关并发症发生率、留置时间无明显区别,患者耐受性较好;CVP测值则有较明显的区别。结论导管静脉内易位对一般以输液为目的的患者无明显不良影响,如果置管以监测CVP为主要目的 ,则可能需另行置管。

Objective To analysis and explore the cause of intravenous malposition of central venus catheters,its influence to clinical states,and the correspondent processing method and suggestion. Methods 12 patients occurred malposition of central venus catheters in our hospital from January 2004 to February 2010 were analyzed retrospectively to observe and study the catheter＇s sur- vival life, effect of fluid infusion, correlative complications,central venous pressure（CVP） ,and patient tolerance. Results Compared with normal situation,no significant difference was found in survival life, fluid flow, incidence of infection of the patients occurred malposition of central venus catheters,except incidence of catheter embolization and values of CVP,and good patient tolerance was also presented in the patients. Conclusion Intravenous malposition of central venus catheters has no obvious harmful effect to transfusion patients,and the reoperation may be necessary to the pantients with special needs of CVP monitoring.