不同冲封管方法对泵入去甲肾上腺素患者血压波动影响的研究

Study on the effects of different flushing and sealing procedures on blood pressure fluctuation in patients receiving norepinephrine

目的了解不同冲封管方法对使用微量泵持续泵入去甲肾上腺素患者动脉血压的影响。方法采取方便抽样法,选取2016年3月—9月需要经深静脉微量泵泵入去甲肾上腺素治疗的40例神经内科重症监护病房危重患者作为研究对象,随机分成两组,每组各20例。实验组冲封管前先将其中心静脉置管内的药液抽吸出来,再按照常规操作方法进行冲封管;对照组采用常规操作方法进行冲封管。比较两种方法对患者动脉血压的影响。结果本研究实验组冲封管209次,对照组冲封管214次。重复测量方差分析结果显示,两组的收缩压、舒张压和平均动脉压的组间效应和时间效应差异均具有统计学意义(P<0.05),且两组的收缩压、舒张压和平均动脉压干预与时间因素存在交互效应(P<0.05)。结论冲封管前,先抽吸中心静脉置管内的药液,再按照常规操作方法进行冲封管的方法,可降低使用微量泵泵入去甲肾上腺素患者血压骤增的风险。

Objective To explore the effects of different flushing and sealing procedures on blood pressure fluctuation in patients receiving norepinephrine（NE） via micro-pump. Methods A total of 40 cases of critically ill patients receiving intravenous infusion of NE via micro-pump,were randomly divided into two groups（20 cases in each group） from March to September,2016. For the experimental group,the liquid medicine in central venous catheter was sucked out,followed by flushing or sealing the tube according to conventional operation method. For the control group,conventional operation method was used to flush or seal the tube. The effects of two methods on arterial blood pressure were compared. Results Overall 423 flushing and sealing events were recorded among 40 cases in this study （209 in the experimental group and 214 in the control group）. The fluctuation of blood pressure was small in the experimental group,while patients in the control group had significant fluctuation of blood pressure（P〈 0.05）. Conclusion The new method that sucking liquid medicine out of the central venous catheter before flushing or sealing the tube followed by flushing or sealing using conventional operation method can reduce the risk of sudden increase in blood pressure for patients receiving small dose infusion with micro-pump.