食管癌术后中心静脉导管留置时间与护理

Nursing measures and retention time of central venous catheter in esophageal cancer patients underwent radical operation

目的探讨食管癌术后中心静脉导管留置时间与护理方法。方法择期食管癌根治术患者90例，按中心静脉导管留置时间随机分为3组，留置5d组（n=31），留置7d组（n=29）和留置10d组（n=30）。观察中心静脉导管留置期间的局部红肿、疼痛、发热、液体外渗以及导管脱出、堵塞等一般并发症。观察期结束后拔除中心静脉导管，用无菌剪刀剪下尖端5cm，放置于无菌容器内，送细菌培养。结果一般并发症发生率留置5d组为3．2％，留置7d组为20．6％，留置10d组为46．7％，差异有统计学意义（P〈0．01）。静脉导管尖端细菌培养结果留置5d组均为阴性，留置7d组有1例阳性，留置10d组有4例阳性，导管相关性感染的发生率比较，差异有统计学意义（P〈0．05）。结论食管癌根治术后中心静脉导管留置时间一般不应超过7d，能否延长留置时间则取决于护理质量的高低。

Objective To explore nursing measures and retention time of central venous catheter in esophageal cancer patients underwent radical operation. Methods According to retention time of central venous catheters, a total of 90 cases of esophageal carcinoma patients were randomly divided into three groups： 31 cases with 5 days retention time in group I , 29 cases with 7 days retention time in group 11 ; 30 cases with 10 days retention time. Complications of central venous catheter including swelling and pain in punition site, fever, extravasation, extrusion and block of catheter and the bacterial culture of central venous catheter were compared among three groups. Results Incidence of complications in group Ⅰ , group Ⅱ and group Ⅲ were 3.2%, 20.6% and 46.7% respectively. The differences were significant（ P 〈 0. 01 ）. As for the positive of bacteria culture, differences among three groups were significant too, with no case in group Ⅰ, one case in group Ⅱ and 4 cases in group Ⅲ. Conclusions Retention time of central venous catheter should under 7 days. Retention time depends on the quality of nursing care.