经周围静脉置入中心静脉插管降低肿瘤患者静脉炎发生率.docVIP

经周围静脉置入中心静脉插管降低肿瘤患者静脉炎发生率 　【关键词】 肿瘤 　　摘 要：目的：对比肿瘤患者在化疗过程中是否留置中心静脉插管对静脉炎发生率的影响。方法：96例胃肠道和肺部恶性肿瘤患者在化疗过程中，40例患者采用经周围静脉置入中心静脉插管（PICC）的方法进行输液化疗，另外56例则采用一般的周围静脉输液的方法，分别观察其静脉炎的发生率和对化疗的依从性。结果：PICC组无一例出现静脉炎，而对照组有31例出现静脉炎，Plt;0.01,两者的差别有统计学意义。对照组有6例因为严重静脉炎需要改变化疗方案。结论：经周围静脉置入中心静脉插管（PICC）有助于减少静脉炎的发生率，增加病人对化疗的依从性。 　　关键词：中心静脉插管； 静脉炎 　　Decrease Phlebitis by Central Catheterization from Peripheral Vein 　　Abstract: Objective:To compare with the occurrence of phlebitis during chemotherapy process of tumor sufferers between the impact of central catheterization from peripheral vein(PICC) and the impact of peripheral vein.Method: 96 patients suffering from malignant tumor underwent chemotherapy, in which 40 cases were administered chemotherapeutic drugs with centre venous catheterization, another 56 cases (control group) were transfused the same drugs from peripheral vein. The occurrence of phlebitis and the dependence on chemotherapy of all the patients were observed. Result: No phlebitis occurred in the patients performed with PICC, while 31 cases in control group manifested phlebitis (Plt;0.01, compared with the patients undergone PICC). There was a significant statistical difference between the two groups, moreover, 6 cases of the control group had to be changed chemotherapeutic way due to severe phlebitis. Conclusion: PICC is helpful to reducing the occurrence of phlebitis; meanwhile, it also facilitates the dependence on chemotherapy of tumor sufferers. 　　Key words: Central catheterization； Phlebitis 　　在胃癌、结肠癌和肺癌患者的化疗中，由于需要反复使用氟尿嘧啶和长春瑞滨，所以常常会出现静脉炎，加重了病人的痛苦。当出现严重的静脉炎时，还需要改变化疗的给药方式或化疗方案，有些病人甚至会停止治疗，影响到化疗的疗效。从2003年开始，我们在胃癌、结肠癌和肺癌患者的化疗中，如病人同意，予经周围静脉置入中心静脉插管（PICC），大大地减少了静脉炎的发生率，取得了较好的效果。 　　1 临床资料 　　1.1 病例选择：选择2003年1月至2004年12月在我院住院治疗的96例胃癌、结肠癌和肺癌患者，其中胃癌和结肠癌55例，肺癌41例，均经过手术或病理确诊，符合各自的诊断标准。治疗目的在手术后病人为辅助化疗，在晚期患者则为姑息治疗。 　　1.2 用药方法：肺癌：长春瑞滨40mg, iv,d1和d8；顺铂70/m2，ivdrip，d1。胃癌：草铂125mg/m2，ivdrip,d1；亚叶酸钙0.1～0.3，ivdrip，d1；氟尿嘧啶0.5g，iv，d1，然后3～4g/m2, civ, 48h。 　　1.3 静脉通道的建立：深静脉插管采用B.Braun Melsungen A