中华临床营养杂志
中華臨床營養雜誌
중화림상영양잡지
CHINESE JOURNAL OF CLINICAL NUTRITION
2014年
6期
381-386
,共6页
林伟芬%杨西宁%李赛梅%黄显实%卢耀振%陆小萍%农美英%陈海丽
林偉芬%楊西寧%李賽梅%黃顯實%盧耀振%陸小萍%農美英%陳海麗
림위분%양서저%리새매%황현실%로요진%륙소평%농미영%진해려
颈外静脉置管%锁骨下静脉置管%股静脉置管%经外周静脉置入中心静脉导管
頸外靜脈置管%鎖骨下靜脈置管%股靜脈置管%經外週靜脈置入中心靜脈導管
경외정맥치관%쇄골하정맥치관%고정맥치관%경외주정맥치입중심정맥도관
External jugular vein catheter%Subclavian vein catheter%Femoral vein catheter%Peripherally inserted central catheter
目的 在肺癌患者中比较颈外静脉置管、锁骨下静脉置管、经外周静脉置入中心静脉导管(PICC)和股静脉置管的效果,探讨肺癌患者治疗的最佳中心静脉置管途径.方法 对2007年12月至2013年4月275例在我院行中心静脉置管的肺癌患者进行回顾性分析,其中颈外静脉置管38例、锁骨下静脉置管96例、PICC 106例和股静脉置管35例,比较4种不同置管方式的一次置管成功率、置管总成功率、平均置管时间、导管平均置管时间、并发症发生率及患者舒适度.结果 4组深静脉一次置管成功、二次置管成功和总置管成功率差异均无统计学意义(P=0.595);平均置管时间差异有统计学意义(P =0.000),平均导管留置时间差异也有统计学意义(P =0.000).各组间两两比较,PICC组平均置管时间显著短于颈外静脉组、锁骨下静脉组和股静脉组(P =0.004,P=0.003,P=0.006),平均导管留置时间显著长于其余3组(P=0.001,P=0.000,P=0.002).置管过程和导管留置过程总并发症发生率的差异有统计学意义(P=0.002);患者舒适度与4种不同深静脉置管方式有相关性(r=0.318,P=0.000).结论 4种深静脉置管术成功率均很高,为成熟的操作技术.可针对肺癌患者的不同情况选择适宜的深静脉置管方式.
目的 在肺癌患者中比較頸外靜脈置管、鎖骨下靜脈置管、經外週靜脈置入中心靜脈導管(PICC)和股靜脈置管的效果,探討肺癌患者治療的最佳中心靜脈置管途徑.方法 對2007年12月至2013年4月275例在我院行中心靜脈置管的肺癌患者進行迴顧性分析,其中頸外靜脈置管38例、鎖骨下靜脈置管96例、PICC 106例和股靜脈置管35例,比較4種不同置管方式的一次置管成功率、置管總成功率、平均置管時間、導管平均置管時間、併髮癥髮生率及患者舒適度.結果 4組深靜脈一次置管成功、二次置管成功和總置管成功率差異均無統計學意義(P=0.595);平均置管時間差異有統計學意義(P =0.000),平均導管留置時間差異也有統計學意義(P =0.000).各組間兩兩比較,PICC組平均置管時間顯著短于頸外靜脈組、鎖骨下靜脈組和股靜脈組(P =0.004,P=0.003,P=0.006),平均導管留置時間顯著長于其餘3組(P=0.001,P=0.000,P=0.002).置管過程和導管留置過程總併髮癥髮生率的差異有統計學意義(P=0.002);患者舒適度與4種不同深靜脈置管方式有相關性(r=0.318,P=0.000).結論 4種深靜脈置管術成功率均很高,為成熟的操作技術.可針對肺癌患者的不同情況選擇適宜的深靜脈置管方式.
목적 재폐암환자중비교경외정맥치관、쇄골하정맥치관、경외주정맥치입중심정맥도관(PICC)화고정맥치관적효과,탐토폐암환자치료적최가중심정맥치관도경.방법 대2007년12월지2013년4월275례재아원행중심정맥치관적폐암환자진행회고성분석,기중경외정맥치관38례、쇄골하정맥치관96례、PICC 106례화고정맥치관35례,비교4충불동치관방식적일차치관성공솔、치관총성공솔、평균치관시간、도관평균치관시간、병발증발생솔급환자서괄도.결과 4조심정맥일차치관성공、이차치관성공화총치관성공솔차이균무통계학의의(P=0.595);평균치관시간차이유통계학의의(P =0.000),평균도관류치시간차이야유통계학의의(P =0.000).각조간량량비교,PICC조평균치관시간현저단우경외정맥조、쇄골하정맥조화고정맥조(P =0.004,P=0.003,P=0.006),평균도관류치시간현저장우기여3조(P=0.001,P=0.000,P=0.002).치관과정화도관류치과정총병발증발생솔적차이유통계학의의(P=0.002);환자서괄도여4충불동심정맥치관방식유상관성(r=0.318,P=0.000).결론 4충심정맥치관술성공솔균흔고,위성숙적조작기술.가침대폐암환자적불동정황선택괄의적심정맥치관방식.
Objective To investigate the optimal method of catheterization for lung cancer patients by comparing external jugular vein catheter,subclavian vein catheter,peripherally inserted central catheter (PICC) and femoral vein catheter.Methods 275 lung cancer patients treated with the 4 types of catheterization were selected for this retrospective review from December 2007 to April 2013,including 38 who were inserted with external jugular vein catheter,96 with subclavian vein catheter,106 with PICC,and 35 with femoral vein catheter.Success rate (one-time and total),mean catheterization time,mean catheter indwelling time,incidences of catheter-related complications,and patient comfort of the 4 groups were compared.Results The success rates of the 4 groups were not significantly different (P =0.595) ; mean catheterization time and catheter indwelling time were significantly different (both P =0.000).The mean catheterization time in the PICC group was significantly shorter than those in the external jugular vein group,subclavian vein group and the femoral vein group (P =0.004,P =0.003,P =0.006),and the mean catheter indwelling time was significantly longer than in the other 3 groups (P =0.001,P =0.000,P =0.002).Total incidence of complications during catheterization and catheter indwelling was significantly different among the 4 groups (P =0.002) ; patient comfort was found correlated with catheterization method (r =0.318,P =0.000).Conclusions The 4 types of deep-vein catheterization are all mature techniques with high success rates.The most appropriate catheterization method should be decided based on individual conditions of each lung cancer patient.
