外周静脉留置针与外周置入中心静脉导管在肿瘤化疗中的应用价值比较_临床医学论文.docVIP

外周静脉留置针与外周置入中心静脉导管在肿瘤化疗中的应用价值比较_临床医学论文 外周静脉留置针与外周置入中心静脉导管在肿瘤化疗中的应用价值比较_临床医学论文 作者：刘绪凤，张宁，李丽霞，高士杰，池连淑 【摘要】 　　目的 比较外周静脉留置针与外周中心静脉置管（PICC）在肿瘤化疗过程中的应用价值。 方法 将2006年1月—2007年4月60例首次化疗的肿瘤患者分为两组，40例外周静脉留置针为A组，20例PICC置管为B组，两组基本情况无明显差异。治疗中观察记录留管时间、并发症发生情况及日常生活能力。 结果 A组留置针保留时间为1~5 d，中位时间3.7 d，B组PICC置管保留时间为15~280 d，中位时间157.5 d；两组比较差异有显著统计学意义（0.001）。两组主要并发症有局部渗出、静脉炎及管腔堵塞。A组发生局部渗血18例、静脉炎29例及管腔堵塞10例，B组发生局部渗血4例、静脉炎1例及管腔堵塞0例。A组日常生活需人照顾，B组日常生活无需人照顾。结论 PICC置管安全、保留时间长，不影响病人的生活质量，在肿瘤病人的化疗中的临床价值显著高于外周静脉留置针。 【关键词】 外周静脉留置针；外周置入中心静脉导管；肿瘤；化学疗法 　　Abstract： Objective To investigate the application of peripherally inserted central catheter (PICC) catheterization to the chemotherapy of malignant tumor, and to compared it with peripheral vein catheterization.Methods Sixty patients were randomly divided into two groups, i.e. peripheral vein catheterization group (Group A, n=40) and PICC group (Group B, n=20). The remaining time of catheters, the complications and the daily living activity were assessed and compared between the two groups. Results Medium time of keeping catheter was 3 days (1-5 days) in Group A and 157 days (15-280 days) in Group B (0.001). The complications were observed, including 18 cases of blood infiltration in Group A and 4 cases in Group B, 29 cases of phlebitis in Group A and 1 case in Group B, 10 cases of occlusion in Group A and none in Group B. The patients in Group A needed aid for daily living activity by care providers, while the patients in Group B didn’t.Conclusion PICC is safe and can be kept for longer time. As a catheterization, it has higher clinical value on the chemotherapy of the patients with tumor and on the improvement in their living quality, and is quite worthy of popularization. 　　Key words： peripheral vein catheterization; peripherally inserted central catheter; tumor; chemotherapy 化疗是肿瘤内科治疗恶性肿瘤的重要手段，临床常用的给药途径是反复浅静脉穿刺给药。由于化疗药物对血管的刺激，将不可避免地造成血管损伤，如操作不当还可使化疗药物外渗，造成局部组织坏死，甚至影响化疗的顺利进行。随着医疗技术的发展，肿瘤病人化疗药物的静脉给药方法变得多样且不断更新[1]。外周置入中心静脉导管（penpherally inserted ce