黑龙江医学
黑龍江醫學
흑룡강의학
HEILONGJIANG MEDICAL JOURNAL
2014年
8期
958-961
,共4页
中心静脉导管%并发症%护理%骨髓造血干细胞移植
中心靜脈導管%併髮癥%護理%骨髓造血榦細胞移植
중심정맥도관%병발증%호리%골수조혈간세포이식
Central venous catheters%Complications%Nurseing%Hematopoietic stem cell transplantation
目的：探讨中心静脉导管在骨髓造血干细胞移植（hematopoietic stem cell transplantation ，HSCT）应用中的并发症类型、发病率、危险因素，进一步探讨护理人员如何防止中心静脉导管（ Central venous catheters ，CVC）并发症。方法收集本院2007-10～2013-10间100例患儿在HSCT中使用CVC的临床资料。结果共出现186次导管并发症，并发症发生率为14.6次/1000 CVC-days。良性血液病导管并发症高于恶性血液病导管并发症（χ2＝5.2，P＝0.02）。 CVC功能障碍发生率为1.7次/1000 CVC-days（11.8％，n＝22），机械性损坏为0.07次/1000 CVC -days （0.5％，n ＝1）；CVC 感染发生率为11.9次/1000 CVC -days （81.2％，n＝151），男患儿导管出口部位感染（CRI）发生率高于女患儿（χ2＝6.42，P＝0.01）。9根（7.9％）CVC导管发生感染导管被移除，70根（61.4％）导管治疗后被移除。经多变量分析，患有非血液疾病CVC并发症发生率高于血液疾病CVC并发症发生率（OR＝2.66，CI ＝1.1～6.2）。男患儿CRI危险性几乎是女患儿的2.5倍（P＝0.01，OR＝2.68，CI＝1.2～5.8）。结论护理人员必须掌握CVC并发症并不断学习CVC的指导方针和实践标准，严格执行无菌技术，具有能够处理CVC各个方面的能力。
目的：探討中心靜脈導管在骨髓造血榦細胞移植（hematopoietic stem cell transplantation ，HSCT）應用中的併髮癥類型、髮病率、危險因素，進一步探討護理人員如何防止中心靜脈導管（ Central venous catheters ，CVC）併髮癥。方法收集本院2007-10～2013-10間100例患兒在HSCT中使用CVC的臨床資料。結果共齣現186次導管併髮癥，併髮癥髮生率為14.6次/1000 CVC-days。良性血液病導管併髮癥高于噁性血液病導管併髮癥（χ2＝5.2，P＝0.02）。 CVC功能障礙髮生率為1.7次/1000 CVC-days（11.8％，n＝22），機械性損壞為0.07次/1000 CVC -days （0.5％，n ＝1）；CVC 感染髮生率為11.9次/1000 CVC -days （81.2％，n＝151），男患兒導管齣口部位感染（CRI）髮生率高于女患兒（χ2＝6.42，P＝0.01）。9根（7.9％）CVC導管髮生感染導管被移除，70根（61.4％）導管治療後被移除。經多變量分析，患有非血液疾病CVC併髮癥髮生率高于血液疾病CVC併髮癥髮生率（OR＝2.66，CI ＝1.1～6.2）。男患兒CRI危險性幾乎是女患兒的2.5倍（P＝0.01，OR＝2.68，CI＝1.2～5.8）。結論護理人員必鬚掌握CVC併髮癥併不斷學習CVC的指導方針和實踐標準，嚴格執行無菌技術，具有能夠處理CVC各箇方麵的能力。
목적：탐토중심정맥도관재골수조혈간세포이식（hematopoietic stem cell transplantation ，HSCT）응용중적병발증류형、발병솔、위험인소，진일보탐토호리인원여하방지중심정맥도관（ Central venous catheters ，CVC）병발증。방법수집본원2007-10～2013-10간100례환인재HSCT중사용CVC적림상자료。결과공출현186차도관병발증，병발증발생솔위14.6차/1000 CVC-days。량성혈액병도관병발증고우악성혈액병도관병발증（χ2＝5.2，P＝0.02）。 CVC공능장애발생솔위1.7차/1000 CVC-days（11.8％，n＝22），궤계성손배위0.07차/1000 CVC -days （0.5％，n ＝1）；CVC 감염발생솔위11.9차/1000 CVC -days （81.2％，n＝151），남환인도관출구부위감염（CRI）발생솔고우녀환인（χ2＝6.42，P＝0.01）。9근（7.9％）CVC도관발생감염도관피이제，70근（61.4％）도관치료후피이제。경다변량분석，환유비혈액질병CVC병발증발생솔고우혈액질병CVC병발증발생솔（OR＝2.66，CI ＝1.1～6.2）。남환인CRI위험성궤호시녀환인적2.5배（P＝0.01，OR＝2.68，CI＝1.2～5.8）。결론호리인원필수장악CVC병발증병불단학습CVC적지도방침화실천표준，엄격집행무균기술，구유능구처리CVC각개방면적능력。
Objective To explore the types , incidence and risk factors of the complications related to CVC used in children undergoing HSCT,and to explore how nurses should have a greater awareness of the prevention of complications .Methods Medical records were analyzed on 100 patients with CVC between October 2007 and October 2013.Results Overall , 186 complications were documented.The overall complication rate was 14.6/1000 CVC -days.Catheter complications were higher in nonmalignant disorders than hematological malignancies (χ2 =5.2, P=0.02).CVC malfunction rates were 1.7/1000 CVC-days (11.8%, n=22) and 0.07/1000 CVC-days for mechanical complications ( 0.5%, n=1 ).The overall CRI rate was 11.9/1000 CVC-days ( 81.2%, n=151 ).CRI episodes were higher in male than female children (χ2 =6.42, P=0.01).Nine CVC (7.9%) were removed due to infection, 70(61.4%) were removed at the end of therapy.In children who had nonhematological diseases , the rate of complications of CVC were higher than in those with hematological diseases ( odds ratio [ OR]=2.66 , concidence interval [ CI]=1.1~6.2.The risk for CRI in male children was nearly 2.5 times more compared with female children ( P =0.01 , OR =2.68 , CI =1.2 ~5.8 ).Conclusion Nurses must be aware of CVC complications and must follow guidelines and practice standards continuously.Rigorous attention should be paid to the aseptic technique . These are essential in all aspects of appropriate management of CVC.
