中心静脉导管腹腔置入的应用观察

Application and observation of placing central venous catheter into abdominal cavity

目的观察中心静脉导管腹腔置入的可行性及临床应用效果。方法将大量腹水的46例患者随机分为A、B两组,每组23例,A组为中心静脉导管腹腔置入组,B组为传统的腹腔穿刺术组。结果 A组把中心静脉导管置入腹腔,每例患者平均腹腔穿刺(1.1±0.1)次,平均累计放液(18 210±65)mL,平均注药次数(1.5±0.2)次,临床症状好转21例,好转率为91.3%。B组给予反复腹腔穿刺术抽液,每例患者平均穿刺次数(3.3±0.2)次,平均累计抽液(9 750±70)mL,平均注药次数(0.7±0.1)次,临床症状好转16例,好转率为69.6%。两组的腹腔穿刺次数、放液量、腹腔注药和临床症状好转的对比差异有统计学意义(P<0.05),A组优于B组。结论中心静脉导管腹腔置入操作简单,不需要反复穿刺,放液、腹腔注药效果好,副作用少,在大量腹水时值得应用。

Objective To observe the feasibility and the clinical effect of placing central venous catheter into the abdominal cavity.Methods 46 patients with massive ascites were randomly divided into two groups： group A and group B,23 cases in each group,The patients in group A were placed central venous catheter into abdominal cavity.Group B was the traditional abdominal puncture’s group.Results The central venous catheter was inserted into the abdominal cavity of patients in group A,each patient’s average abdominal puncture was（1.1±0.1） times,average accumulative total put liquid was（18 210＋65） mL,average note medicine was（1.5±0.2） times the number,clinical symptoms improved 21 cases,the recovery was 91.3%.Group B give repeated technic of abdominal smoke fluid,each patient’s average abdominal puncture was（3.3±0.2） times,average accumulative total put liquid was（9 750±70） mL,the mean number of injcetion was（0.7±0.1） times,clinical symptoms of 16 cases improved,the recovery rate was 69.6%.There were significant differences between the two groups with puncture number,releasing ascites,injecting the drugs into abdominal cavity,improving clinical symptoms（P 〈0.05）.Group A was better than group B.Conclusion The techniques of placing central venous catheter into the abdominal cavity has simple operation,good effect in releasing ascites and injecting the drugs into abdominal cavity,few side effect and should be used in massive ascites