本文選題：經(jīng)外周置入中心靜脈導(dǎo)管 + 呼吸危重癥　； 參考：《重慶醫(yī)科大學(xué)學(xué)報(bào)》2017年01期

【摘要】：目的:前瞻性評(píng)估雙腔耐高壓注射型經(jīng)外周置入中心靜脈導(dǎo)管(power peripherally inserted central catheter,Power PICC)臨床應(yīng)用于呼吸危重癥患者的可行性。方法:選取2014年1月至2015年12月在重慶醫(yī)科大學(xué)附屬第一醫(yī)院呼吸內(nèi)科重癥監(jiān)護(hù)室(intensive care unit,ICU)進(jìn)行經(jīng)外周置入中心靜脈導(dǎo)管(peripherally inserted central catheter,PICC)置管的患者187例作為研究對(duì)象,其中行雙腔Power PICC置管患者100例,行三向瓣膜導(dǎo)管置管患者87例,前瞻性分析兩組患者在一般資料、導(dǎo)管留置時(shí)間、住院時(shí)間、住院費(fèi)用、患者滿意度、護(hù)理工作量及導(dǎo)管相關(guān)并發(fā)癥發(fā)生率方面的差異性。結(jié)果:2組患者在一般資料、導(dǎo)管留置時(shí)間、住院時(shí)間及住院費(fèi)用方面無統(tǒng)計(jì)學(xué)差異;導(dǎo)管并發(fā)癥方面:雙腔Power PICC組導(dǎo)管斷裂的發(fā)生率低于三向瓣膜導(dǎo)管,而堵管率及靜脈血栓發(fā)生率略高于三向瓣膜PICC組,2組間差異無統(tǒng)計(jì)學(xué)意義;但雙腔Power PICC導(dǎo)管可減輕患者反復(fù)穿刺的痛苦,故患者滿意度高于三向瓣膜導(dǎo)管,兩組間差異有顯著統(tǒng)計(jì)學(xué)意義;由于三向瓣膜PICC組需要再次穿刺外周血管,導(dǎo)致輸液相關(guān)并發(fā)癥的發(fā)生率增高,故護(hù)理工作量高于雙腔Power PICC組。結(jié)論:雙腔Power PICC導(dǎo)管能滿足呼吸危重癥患者多通道連續(xù)給藥、持續(xù)血流動(dòng)力學(xué)監(jiān)測(cè)、胃腸外營(yíng)養(yǎng)、加強(qiáng)電子計(jì)算機(jī)斷層掃描(computed tomography,CT)造影以及血標(biāo)本的采集,尤其對(duì)于凝血功能障礙的患者具有突出的優(yōu)勢(shì),值得在危重癥患者中推廣使用。
[Abstract]:Objective: to prospectively evaluate the feasibility of double lumen high pressure injection (power peripherally inserted central catheterpower PICC) for respiratory critical patients. Methods: from January 2014 to December 2015, 187 patients with central venous catheterization (peripherally inserted central) were placed in the intensive care unit of Department of Respiratory Medicine (intensive care Unit ICU) of the first affiliated Hospital of Chongqing Medical University. Among them, 100 patients were treated with Power PICC with double lumen and 87 patients with three-way valve catheterization. The general data, catheter indwelling time, hospitalization cost, patient satisfaction were analyzed prospectively in the two groups. Differences in nursing workload and incidence of catheter-related complications. Results there was no significant difference in general data, catheter indwelling time, hospital stay time and hospitalization expenses between the two groups, and the incidence of catheter rupture in double lumen Power PICC group was lower than that in three-way valvular catheter. However, there was no significant difference between the two groups in the rate of catheter occlusion and the incidence of venous thrombosis, but the patients' satisfaction was higher than that of the three-way valve catheter because of the reduction of the pain of repeated puncture by double-lumen power PICC catheter. There was a significant difference between the two groups. Because of the need to puncture the peripheral blood vessels again in the three-way valve PICC group, the incidence of transfusion related complications increased, so the nursing workload was higher than that in the double-lumen Power PICC group. Conclusion: the double lumen Power PICC catheter can be used for continuous multichannel administration, continuous hemodynamic monitoring, parenteral nutrition, enhanced computed tomographic CT, and blood sample collection. Especially for the patients with coagulation dysfunction, it is worthy to be widely used in critically ill patients.
【作者單位】： 重慶醫(yī)科大學(xué)附屬第一醫(yī)院呼吸內(nèi)科;
【分類號(hào)】：R473.5
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本文編號(hào)：2115295