摘要
目的基于倾向性评分匹配法探讨经中等长度静脉导管输注刺激性药物对置管患者的影响,为制订针对性干预提供参考。方法采用回顾性队列研究方法,分析2019年3月至2022年10月浙江大学医学院附属邵逸夫医院1539例中等长度静脉导管置管患者的临床资料,根据患者输注药物的性质分为刺激性药物组1120例和非刺激性药物组419例,然后基于倾向性评分匹配法比较2组患者导管相关并发症发生率及导管留置时间。结果1539例患者中,男656例,女883例,年龄18~92(59.30±18.76)岁。倾向性评分匹配前刺激性药物组与非刺激性药物组患者的年龄、高血压例数、糖尿病例数、白细胞计数分别为(58.09±18.72)岁、496例、266例、7.50(5.50,9.70)×10^(9)/L和(62.55±18.50)岁、210例、129例、7.00(5.10,9.50)×10^(9)/L,2组比较差异均有统计学意义(t=4.18,χ^(2)=4.18、7.92,Z=-1.98,均P<0.05)。采用倾向性评分匹配成功后刺激性药物组患者412例,非刺激性药物组患者412例,匹配后2组患者一般资料比较差异无统计学意义(均P>0.05)。匹配后2组患者渗液、渗血、导管堵管、导管相关性血栓、导管脱出及导管总并发症发生率比较差异均无统计学意义(均P>0.05),刺激性药物组导管留置时间为10.00(5.25,16.75)d,长于非刺激性药物组的6.00(4.00,11.00)d,差异有统计学意义(Z=-7.25,P<0.05)。结论输注刺激性药物对中等长度静脉导管置管患者静脉导管结局均无影响,但经中等长度静脉导管输注刺激性药物时应加强监测及导管维护,以期减少导管相关并发症的发生。
Objective To explore the effects of infusion of irritant medications on the patients with midline catheter based on propensity score matching method and provide reference for medications infusion through midline catheter.Methods Through a retrospective cohort study,the clinical data of 1539 patients with midline catheter placement in Sir Run Run Shaw Hospital,Zhejiang University School of Medicine from March 2019 to October 2022 were retrospectively analyzed,and the patients were divided into irritant medications group(n=1120)and non-irritant medications group(n=419)according to the characteristics of the medications they were infused with,and then compared the patients of the two groups with midline catheter-related complications and catheter indwelling time based on the propensity score matching.Results Among 1539 patients,there were 656 males and 883 females,aged 18-92(59.30±18.76)years old.Before propensity score matching,there were statistically significant differences in age:(58.09±18.72)years old,(62.55±18.50)years old;hypertension:496 cases,210 cases;diabetes:266 cases,129 cases;white blood cell count:7.50(5.50,9.70)×10^(9)/L,7.00(5.10,9.50)×10^(9)/L between the irritant medications group and non-irritant medications group(t=4.18,χ^(2)=4.18,7.92,Z=-1.98,all P<0.05).After propensity score matching,there were 412 patients in the irritant medications group and 412 patients in the non-irritant medications group,and there was no significant difference in the general data between the two groups(all P>0.05).After propensity score matching,the rates of oozing,bleeding,catheter occlusion,catheter-related thrombosis,catheter dislodgement and total catheter complications between the two groups showed no statistically significant difference(all P>0.05).The catheter indwelling time in the irritant medications group was 10.00(5.25,16.75)days,which was longer than that in the non-irritant medications group for 6.00(4.00,11.00)days,the difference was statistically significant(Z=-7.25,P<0.05).Conclusions Infusion of irritant medications has no effect on the outcome of midline catheter,but monitoring and catheter maintenance should be strengthened in order to reduce the occurrence of cutheter related complications.
作者
徐文婷
刘畅
李祥云
王洁
曹秀珠
赵林芳
Xu Wenting;Liu Chang;Li Xiangyun;Wang Jie;Cao Xiuzhu;Zhao Linfang(Department of Vascular Access Team Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China;Department of Public Health and Management,Wenzhou Medical University School,Wenzhou 325035,China)
出处
《中国实用护理杂志》
2024年第30期2351-2357,共7页
Chinese Journal of Practical Nursing
基金
浙江大学医学院附属邵逸夫医院护理临床研究项目(2024HLKY06)。