股静脉置管早期穿刺口渗液原因分析及处理对策

Study on the cause of puncture exudate after Femoral vein catheter and the countermeasures.

目的探讨股静脉置管后早期穿刺口渗液的原因和有效的处理对策。方法对股静脉置管化疗出现穿刺口局部渗液的12例患者临床资料进行分析,加强换药并观察穿刺口有无红肿、疼痛、脓性分泌物、组织坏死,拔管后取导管头细菌培养。结果股静脉置管早期穿刺口渗液主要与穿刺损伤局部组织和淋巴管、使用皮肤扩张器及患者病情有关。经加强换药,局部沙袋按压,12例患者穿刺口均无红肿、疼痛、脓性分泌物、组织坏死,导管头细菌培养为无菌生长。结论股静脉置管后出现穿刺口少量渗液时不要轻易拔管,只要加强换药,就不影响化疗方案实施;为减少股静脉穿刺口渗液发生,置管前应正确评估病情,避免在腹股沟淋巴结肿大区域置管,尽量避免使用皮肤扩张器。

Objective To study the cause of puncture exudate after after Femoral vein catheter and the countermeasures.Methods The clinical data of 12 patients with puncture exudate after Femoral vein catheter were analyzed.The patients received enhanced Dressing,and were observed for swelling,pain,purulent secretions,and tissue necrosis.The bacteria isolated from catheter head after extubation were cultivated and analyzed.Results The puncture exudate was found to be mainly related to puncture-damaged local tissue and lymphatic,use of tissue expander,and the patient＇s condition.Through enhancing dressing and local sandbag pressing,12 patients were all found with no swelling,pain,purulent secretions and tissue necrosis.The cultivated bacteria isolated from catheter head after extubation had sterile growth.Conclusion We should not draw the tube rashly when early puncture exudate appers after femoral vein catheter.It will not affect the implementation of chemotherapy if we enhance dressing.To reduce the occurrence of puncture exudate,the condition of the disease should be properly assessed before catheterization.Besides,catheterization in enlargement area of inguinal lymph nodes and use of skin expanders should be avoided.