PICC在血液肿瘤患者中应用及常见并发症对策.doc

PICC在血液肿瘤患者中应用及常见并发症对策[摘要] 目的 探讨PICC在血液肿瘤患者中的应用价值及常见并发症的处理方法。方法 回顾性复习我院2007年1月～2010年9月采用PICC技术进行治疗的127例血液肿瘤患者的临床资料，并对导管留置期间出现各类并发症的患者资料进行系统分析。结果 127例患者PICC导管一次穿刺成功率93.7%（119/127），置管成功率100%；导管留置时间为3～252d，平均（76.3±19.5）d；导管留置期间共出现各类并发症21例，经相应处理均治愈。结论 PICC在血液肿瘤患者中的应用具有优越性，值得推广，但应注意导管留置期间的护理，并需高度重视对各类并发症的正确处理。 [关键词] PICC；血液肿瘤；并发症 [中图分类号] R473.73 [文献标识码] B [文章编号] 1673-9701（2011）26-110-03 Application of PICC in Patients with Hematological M alignancies and the Countermeasures to Common Complication YE Lingrong XU Qinrong YU Lijuan YU Hong Department of Hematology，Quzhou City the peoples Hospital，Quzhou 324000，China [Abstract] Objective To explore the value of PICC in patient with hematological m alignancies and the countermeasures to common complication. Methods From 2007 January to 2010 September，127 patients with hematological m alignancies were performed PICC，and the complications were detected and recorded，the reasons were analyzed at the same time. Results The success rate of first puncture was 93.7%（119/127）among these 127 patients，the PICC placement success rate was 100%. The PICC dwelling time between 3 - 252 d（76.3±19.5）d. The complications were observed in 21 patients of the total group. Through careful observation and strengthening nursing，all the complications were treated satisfactorily. Conclusion Application of PICC in patient with hematological m alignancies have a lot of superiority and worthy to be spread in clinical practice. We should pay attention to improve nursing quality in the course of PICC dwelling time，and attach importance to all the complications of correctly handling. [Key words] PICC；Hematological m alignancy；Complication 血液肿瘤主要治疗手段为输注化学药物（简称为化疗）及高浓度营养物质，而化疗最常见的毒副作用为局部毒性反应，如静脉炎、血管硬化、闭锁，发疱性化疗药物外渗后容易发生皮下坏死。PICC即经外周静脉穿刺置入中心静脉导管（peripherally inserted central catheters），是一种从外周静脉置入导管，使其末端位于中心静脉的深静脉置管技术，由于该处静脉管腔大，管壁较厚，血流丰富，化疗药物通过PICC管道注入血管后迅速稀释从而解除了药物对血管壁的刺激，避免了药物引起的外周浅静脉炎及外渗性损伤[1]，且PICC管最长可留置1年，避免了反复穿刺外周静脉给患者带来的痛苦，因此尤其适用于肿瘤