老年神经胶质瘤患者外周静脉置入中线导管输液的临床研究

Midline catheter insertion through peripheral venous for giving medications in elderly neurogliocytoma

目的 比较两种不同外周静脉置管方式对老年神经胶质瘤患者临床应用效果的影响.方法 将336例行静脉给药治疗的老年胶质瘤患者采用随机数字表法分为两组：中线导管置入组（168例）和末梢静脉置管组（168例）.记录静脉穿刺时程、置管次数、导管保留时间、置管并发症发生率和患者满意度. 结果 中线导管置入组静脉穿刺时程[（25.3±1.8）min比（0.8±0.1）min]和保留导管时间[（27.5±1.0）d比（2.9±0.4）d]长于末梢静脉置管组,在置管次数方面,中线导管置入组少于末梢静脉置管组（1.1±0.3比12.2±0.4）（P＜0.05）.中线导管置入组的静脉炎发生率低于末梢静脉置管组[8例（4.8％）比51例（30.4％）]（P＜0.05）.在导管阻塞、移位和拔出困难方面的发生率两组差异无统计学意义（P＞0.05）.中线导管置入组患者满意度高于末梢静脉置管组（89.0％比63.0％,P＜0.05）. 结论 对于老年神经胶质瘤患者,通过置入外周静脉的中线导管给药是适宜的给药方式,可降低静脉炎发生率,减少穿刺损伤,并提高患者满意度.

Objective To compare the effects of two types of peripheral venous insertion of catheter in elderly patients with neurogliocytoma.Methods A total of 336 neurogliocytoma patients received intravenous drug treatment were randomly divided into two groups：midline catheter group （n =168） and periphery catheter group （n=168）.The time course of venous insertion of catheter,frequency of insertion,time of catheter reservation,incidence of insertion complications and degree of satisfaction in patients were recorded.Results The time course of venous insertion and the time of catheter reservation were longer in midline group than in periphery group [（25.3±1.8） min vs.（0.8±0.1） min,（27.5±1.0） d vs.（2.9±0.4） d,respectively,both P〈0.05].The frequency of insertion and the incidence of phlebitis were lower in midline group than in periphery group [（1.1±0.3） vs.（12.2±0.4）,8 cases （4.8%） vs.51 cases （30.4%）,respectively,both P〈0.05].There were no significant differences in catheter occlusion,migration and removal between the two groups （all P〉 0.05）.The degree of satisfaction was higher in midline group than in periphery group （89.0% vs.63.0%,P 〈 0.05）.Conclusions It is suitable for elderly patients with neurogliocytoma to recieve intravenous drug treatment by midline catheter insertion.Midline catheter insertion can reduce the incidence of phlebitis and puncture damage,and elevate the degree of satisfaction.