植入式静脉输液港和经外周静脉穿刺置入中心静脉导管在白血病患者化疗中的应用效果比较

Comparison of the practical effects of implantable venous access port and peripherally inserted central catheter in leukemia patients

目的比较行化疗白血病患者开展植入式静脉输液港和经外周静脉穿刺置入中心静脉导管的应用效果。方法将接受化疗的90例白血病患者作为研究对象,按照其接受干预方式的差异分为研究组和对照组,每组45例。对照组患者接受经外周静脉穿刺置入中心静脉导管,研究组患者接受植入式静脉输液港置管。对比两组患者的1次置管成功率,置管1、3、6、12个月时的置管留置率,置管12个月内的意外拔管率及并发症发生率,置管12个月时的生存质量及服务满意度评分。结果研究组患者1次置管成功率为80.00%(36/45),显著低于对照组的95.56%(43/45)(P<0.05)。两组患者置管1个月时的置管留置率比较,差异无统计学意义(P>0.05);研究组患者置管3、6、12个月时的置管留置率分别为93.33%、68.89%、44.44%,高于对照组的53.33%、26.67%、0(P<0.05)。随访至12个月时,研究组患者未出现意外拔管情况,对照组患者出现意外拔管4例(8.89%),研究组患者意外拔管率低于对照组(P<0.05)。随访至12个月,研究组患者并发症发生率为4.44%(2/45),显著低于对照组的48.89%(22/45)(P<0.05)。研究组患者置管12个月时生存质量评分(123.65±20.15)分和服务满意度评分(86.53±4.16)分均显著高于对照组的(101.23±15.60)、(79.63±3.56)分(P<0.05)。结论相较于经外周静脉穿刺置入中心静脉导管,虽然植入式静脉输液港1次置管成功率更低,但后续置管留置率明显更高,意外拔管率和各类并发症发生率更低,且有助于提高患者的远期生存质量和服务满意度,建议临床推广应用。

Objective To compare the practical effects between implantable venous access port and peripherally inserted central catheter in leukemia patients in patients undergoing chemotherapy for leukemia.Methods A total of 90 leukemia patients who received chemotherapy were selected as study subjects and divided into the study group and the control group according to the differences in the way of intervention,with 45 patients in each group.Patients in the control group used peripherally inserted central catheter,while patients in the study group used implantable venous access port.Both groups were compared in terms of success rate of one catheterization,the rate of catheter retention after1,3,6 and 12 months of catheterization,the rate of accidental extubation and the incidence of complications within 12 months of catheterization,and the quality of life score and service satisfaction score after 12 months of catheterization.Results The success rate of one catheterization in the study group was 80.00%(36/45),which was significantly lower than 95.56%(43/45)in the control group(P<0.05).After 1 month of catheterization,the rate of catheter retention of the two groups was not statistically significant(P>0.05).After 3,6 and 12 months of catheterization,the rate of catheter retention in the study group were 93.33%,68.89%and 44.44%,which were higher than 53.33%,26.67%and 0 in the control group(P<0.05).At 12 months follow-up,there were no cases of accidental extubation in the study group,but 4 cases(8.89%)in the control group;the rate of accidental extubation of the study group was lower than the control group(P<0.05).At 12 months follow-up,the incidence of complications of the study group was 4.44%(2/45),which was significantly lower than 48.89%(22/45)of the control group(P<0.05).After 12 months of catheterization,the scores of quality of life and service satisfaction of patients in the study group were(123.65±20.15)and(86.53±4.16)points,which were significantly higher than(101.23±15.60)and(79.63±3.56)points in the control group(P<0.05).Conclusion Compared with peripherally inserted central catheter,although the success rate of one catheterization of implantable venous access port is lower,the rate of catheter retention subsequent is significantly higher,the rate of accidental extubation and the incidence of various complications are lower,and it is helpful to improve the long-term quality of life and service satisfaction of patients,suggesting clinical promotion and application.