两种经外周静脉置入中心静脉导管冲封管方法的效果比较

Comparison of two different irrigation and sealing methods for peripherally inserted central catheter

目的了解采用中心静脉导管冲洗器及采用预充式导管冲洗器配合肝素稀释液用于经外周静脉置入中心静脉导管(peripherally inserted central catheter,PICC)冲封管的效果,为凝血功能较差、有出血倾向患者的PICC置管维护中封管液的选择与使用提供参考。方法由统计分析SAS软件产生随机数字,将52例行PICC输液的患者随机分为试验组和对照组,每组各26例。试验组采用中心静脉导管冲洗器进行PICC冲封管;对照组采用预充式导管冲洗器配合肝素稀释液进行PICC冲封管,了解及比较两组PICC导管堵管、非计划拔管等并发症发生情况及冲封管次数的差异。结果试验组共冲管(8.6±2.7)次,对照组(9.6±3.1)次,两组比较,差异无统计学意义(t=-1.297,P=0.201)。两组均未发生PICC导管堵管、非计划拔管及静脉炎、导管相关性血栓、导管相关性血流感染等并发症。结论对于凝血较差和有出血倾向的患者在进行PICC冲封管时,可采用中心静脉导管冲洗器进行冲封管,以降低此类患者使用肝素稀释液封管发生的相关风险。

Objective To investigate the effects of prefilled catheter irrigator combined with heparin sodium sealing vs ordinary central venous catheter(PICC)procedure in the irrigation and sealing of PICC and to provide references for selecting the irrigation and sealing solution for patients with poor clotting function.Methods A random number table was made by SAS software.Fifty-two patients with PICC infusion were randomly divided into an trial group and a control group in equal number.In the trial group,PICC irrigators were used for irrigation and sealing and the control group with prefilled catheter irrigation containing heparin sodium solution.The two groups were compared with the rate of catheter blockage,rate of unplanned catheter withdrawal and frequencies of irrigation and sealing.Results There was no significant difference in the frequency of irrigations between the trial and control groups(8.6±2.7)vs.9.6±3.1;t=-1.297,P=0.201.The catheter blockage,unplanned catheter withdrawal,phlebitis,catheter-related thrombosis and bloodstream infection were not observed in both groups.Conclusion For irrigation and sealing of PICC in patients with poor clotting function,PICC irrigators can be a choice to reduce the risks by using the prefilled sealing with heparin sodium solution.