三种静脉置管在神经内科患者中应用效果的比较

Comparisons on Clinical Effects of Three Types of Venous Catheters in Neurologic Patients

目的探讨颈内静脉置管(internal jugular vein catheter,JVC)、股静脉置管(femoral vein catheter,FVC)和外周中心静脉置管(peripheral central venous catheter,PICC)在神经内科患者中应用的效果。方法便利抽样法选取2007年3月至2011年7月在杭州市第三人民医院神经内科就诊的327例患者为研究对象,按其置管方式的不同将其分为JVC组(n=108)、FVC组(n=63)和PICC组(n=156),比较三种静脉置管方法在静脉一次穿刺成功率、导管留置时间、并发症和患者舒适程度方面的差异。结果 FVC组和PICC组静脉一次穿刺成功率分别为93.65%和93.59%,三种静脉置管方法静脉一次穿刺成功率的差异无统计学意义(P>0.05);PICC留置时间最长,平均为(119.78±33.52)d(P<0.05);三种置管方法在误入动脉、气胸、导管堵塞、血肿、静脉炎和感染发生率方面差异均有统计学意义(P<0.05或P<0.01);PICC组患者舒适度最好(P<0.05)。结论 PICC在神经内科患者中的临床应用效果较好,值得推广。

Objective To explore the clinical effects of internal jugular vein catheter（JVC）, femoral vein catheter（FVC）and peripheral central venous catheter（PICC）in neurologic patients. Methods From March 2007 to July 2011,327 neurologic patients in the hospital were enrolled in the study and divided into JVC group （n = 108）, FVC group （n = 63） and PICC group （n = 156） according to catheterization methods. Com- parisons were conducted on the one-time success rate of puncture, catheter indwelling time, complications, and patient＇s comfort levels among the three groups. Results The one-time venipuncture success rates in FVC group and PICC group were 93.65 %, 93.59 %. There was no significant difference on the one-time success rate of catheterization of three venipuncture catheterization（P〉0.05）. The indwelling time was longest in PICC group, with an average of（l19.78±33.52）d. Significant differences were observed on cath- eter strayed into the artery, pneumothorax, catheter blockage, hematoma, phlebitis, and infection rates for the three types of venous catheters（P〈0.05 or P〈0.01）. The top comfort level was in PICC group. Conclusion PICC has good clinical effect of neurologic patients,and thus deserves further clinical application.