肝硬化患者应用PICC输液治疗的临床体会

Clinical Experience of PICC Infusion Therapy for Patients with Liver Cirrhosis

目的探讨肝硬化患者置入中心静脉导管(peripherally inserted central venous catheter,PICC)输血或用药的临床特点。方法选取2018年1月—2022年12月在徐州市传染病医院肝炎内科输液治疗的肝硬化患者90例,对所有患者的临床相关资料进行回顾性分析。依据患者置管方式的不同,将行PICC置管的患者纳入PICC组,将行中心静脉导管(central venous catheter,CVC)置管的患者纳入CVC组。比较两组置管时间、治疗完成率、并发症发生率与治疗满意率等。结果PICC组平均置管时间(144.3±56.6)d,长于对照组的(13.9±4.6)d,差异有统计学意义(P<0.05)。PICC组治疗完成率92.5%,高于对照组的60.0%,差异有统计学意义(P<0.05)。PICC组并发症发生率低于对照组,治疗满意率高于对照组,穿刺点瘢痕长度大于对照组,差异均有统计学意义(P<0.05)。结论肝硬化患者应用PICC进行静脉治疗的置管时间长、并发症少、患者治疗满意率较高,但穿刺点瘢痕较CVC长,临床应用时应根据患者具体情况合理选择。

Objective To explore the clinical characteristics of blood transfusion or drug use in liver cirrhosis patients with peripherally inserted central venous catheter(PICC). Methods A total of 90 patients with liver cirrhosis who received infusion treatment in the Department of Hepatitis, Xuzhou Infectious Diseases Hospital from January 2018 to December 2022 were selected, and retrospectively analyzed the clinical data of all patients. According to the different ways of patient catheterization, the patients who underwent PICC catheterization were included in the PICC group, and the patients who underwent central venous catheter(CVC) catheterization were included in the CVC group. Compare the catheterization time, treatment completion rate, incidence of complications, and treatment satisfaction rate between the two groups. Results The average catheterization time in the PICC group was(144.3 ± 56.6) days, which was significantly longer than(13.9 ± 4.6) days of the control group(P<0.05). The completion rate of treatment in the PICC group was 92.5%, significantly higher than 60.0% in the control group(P<0.05). The incidence of complications in the PICC group was significantly lower than that in the control group, the treatment satisfaction rate was significantly higher than that in the control group, and the scar length at the puncture point in PICC group was significantly longer than that in the control group(all P<0.05). Conclusion The use of PICC for venous therapy in patients with liver cirrhosis has the advantages of longer catheterization time, fewer complications, and higher patient satisfaction rate. However, the scar at the puncture point is longer than that of CVC,and clinical application should be reasonably selected based on the specific situation of the patient.