双腔Power PICC导管在呼吸危重症患者中的应用研究

发布时间：2018-07-11 13:05

  本文选题：经外周置入中心静脉导管 + 呼吸危重症　； 参考：《重庆医科大学学报》2017年01期

【摘要】：目的:前瞻性评估双腔耐高压注射型经外周置入中心静脉导管(power peripherally inserted central catheter,Power PICC)临床应用于呼吸危重症患者的可行性。方法:选取2014年1月至2015年12月在重庆医科大学附属第一医院呼吸内科重症监护室(intensive care unit,ICU)进行经外周置入中心静脉导管(peripherally inserted central catheter,PICC)置管的患者187例作为研究对象,其中行双腔Power PICC置管患者100例,行三向瓣膜导管置管患者87例,前瞻性分析两组患者在一般资料、导管留置时间、住院时间、住院费用、患者满意度、护理工作量及导管相关并发症发生率方面的差异性。结果:2组患者在一般资料、导管留置时间、住院时间及住院费用方面无统计学差异;导管并发症方面:双腔Power PICC组导管断裂的发生率低于三向瓣膜导管,而堵管率及静脉血栓发生率略高于三向瓣膜PICC组,2组间差异无统计学意义;但双腔Power PICC导管可减轻患者反复穿刺的痛苦,故患者满意度高于三向瓣膜导管,两组间差异有显著统计学意义;由于三向瓣膜PICC组需要再次穿刺外周血管,导致输液相关并发症的发生率增高,故护理工作量高于双腔Power PICC组。结论:双腔Power PICC导管能满足呼吸危重症患者多通道连续给药、持续血流动力学监测、胃肠外营养、加强电子计算机断层扫描(computed tomography,CT)造影以及血标本的采集,尤其对于凝血功能障碍的患者具有突出的优势,值得在危重症患者中推广使用。
[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.
【作者单位】： 重庆医科大学附属第一医院呼吸内科;
【分类号】：R473.5
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本文编号：2115295