尿激酶封管用于癌症患者PICC导管维护的观察

Application of urokinase tube sealing in maintenance of peripherally inserted central catheter in cancer patients

目的:探讨尿激酶封管法在肿瘤患者PICC封管维护中的应用效果及其安全性,并与传统的肝素封管法进行比较。方法:选取接受PICC置管的患者581例,随机分为研究组(286例)与对照组(295例)。研究组采用尿激酶液封管,每2周冲管1次;对照组采用肝素液封管,每周冲管2次。比较两种封管方法的堵管、感染性并发症的发生率及其对患者凝血功能的影响,观察临床实际应用效果。结果:研究组堵管发生率8.39%(24/286),对照组为9.15%(27/295),2组差异无统计学意义(P>0.05);2组患者穿刺点感染率、血培养阳性率、凝血功能及DIC指标的变化差异均无统计学意义。结论:PICC置管维护过程中采用尿激酶封管的效果及安全性与肝素封管类似。与传统的肝素封管法相比,尿激酶封管维护间隔时间长,方便了患者,值得临床推广。

Objective： To determine the efficacy and safety of urokinase tube sealing in maintenance of the peripherally inserted central catheter（PICC） ,and to make a comparison with traditional heparin sodium for tube sealing. Methods： 581 cancer patients who underwent PICC were randomly divided into two groups： study gwup （286 cases） and control group （295 cases）. The study group used urokinase fluid to seat the tube once biweekly while the control group used heparin sodium to seal the tube twice weekly. The incidence of tube blockage, infectious complications and their effects on coagulation function were compared between the two methods. Results： The incidence of catheter occlusion was 8.39% （24/286）in the study group, and 9. 15% （27/295）in the control group, and the difference between the two groups was not statistically significant （P 〉 0. 05 ）. Moreover,there were no significant differences in the incidence of infection, positive rate of blood culture, blood coagulation function and the change of DIC indexes between the two groups. Conclusion： The effectiveness and safety of urokinase for tube sealing in PICC maintenance is sinfilar to those of commonly used heparin sodium. Compared with the traditional heparin sodium for tube sealing, urokinase tube sealing has long maintenance interval, which is convenient for patients and worthy of clinical promotion.