CAJ | 학술논문

目的：探讨植入式静脉输液港(IVAP)和超声引导下经外周静脉穿刺中心静脉置管(PICC)在肿瘤化疗患者中的临床应用，为肿瘤患者选择化疗静脉输液通路提供科学合理的选择依据。方法选择2013年11月~2014年11月在解放军总医院肿瘤内科住院期间接受化疗的81例IVAP置管患者(IVAP组)和241例PICC置管患者(PICC组)，对两组置管一次成功率、管路维护操作时间、置管期间并发症进行比较。结果 IVAP组一次性置管成功率(98.8%)高于PICC组(90.0%)，差异有统计学意义(P<0.05)。 IVAP组管路维护的操作时间为(11.22±2.31)min，明显低于PICC组[(15.17±3.65)min]，差异有统计学意义(P<0.05)。 IVAP组导管相关并发症为穿刺点感染(1例)和皮疹(1例)，无静脉炎、静脉血栓；PICC组为皮疹(21例)、静脉炎(14例)、静脉血栓(13例)等，多发生在置管72 h内；IVAP组导管相关并发症发生率(2.47%)明显低于PICC组(27.80%)，差异有统计学意义(P<0.05)。结论 IVAP明显优于PICC，更适合在肿瘤化疗患者中广泛推广使用。
목적：탐토식입식정맥수액항(IVAP)화초성인도하경외주정맥천자중심정맥치관(PICC)재종류화료환자중적림상응용，위종류환자선택화료정맥수액통로제공과학합리적선택의거。방법선택2013년11월~2014년11월재해방군총의원종류내과주원기간접수화료적81례IVAP치관환자(IVAP조)화241례PICC치관환자(PICC조)，대량조치관일차성공솔、관로유호조작시간、치관기간병발증진행비교。결과 IVAP조일차성치관성공솔(98.8%)고우PICC조(90.0%)，차이유통계학의의(P<0.05)。 IVAP조관로유호적조작시간위(11.22±2.31)min，명현저우PICC조[(15.17±3.65)min]，차이유통계학의의(P<0.05)。 IVAP조도관상관병발증위천자점감염(1례)화피진(1례)，무정맥염、정맥혈전；PICC조위피진(21례)、정맥염(14례)、정맥혈전(13례)등，다발생재치관72 h내；IVAP조도관상관병발증발생솔(2.47%)명현저우PICC조(27.80%)，차이유통계학의의(P<0.05)。결론 IVAP명현우우PICC，경괄합재종류화료환자중엄범추엄사용。
Objective To evaluate the clinical application of implantable venous access ports (IVAP) and ultrasound-guided peripherally inserted central catheter (PICC), and provide reasonable evidence for tumor patients undergoing chemotherapy. Methods From November 2013 to November 2014, in Department of Oncology of Chinese PLA General Hospital, 241 patients with PICC (PICC group) and 81 patients with IVAP (IVAP group) were selected, the one-time success rate, pipeline maintenance operation time, complications of catheter period of two groups were analyzed. Re-sults The one-time success rate of IVAP group (98.8%) was higher than that of PICC group, the difference was statisti-cally significant (P< 0.05). The pipeline maintenance operation time of IVAP group was (11.22±2.31) min, which was less than that of PICC group [(15.17±3.65) min], the difference was statistically significant (P< 0.05). The complica-tions of catheter period in IVAP group were puncture point infection (1 case) and skin rash (1 case), no phlebitis and venous thrombus occrued;those in PICC group were skin rash (21 cases), phlebitis (14 cases), venous thrombus (13 cas-es) and so on, tending to occur within 72 h, complications incidence rate of catheter period in IVAP group (2.47%) was lower than that in PICC group (27.80%), the difference was statistically significant (P< 0.05). Conclusion IVAP is su-perior to PICC, and it is more suitable for promotion in patients with tumor chemotherapy.