摘要
目的 前瞻性研究外周静脉穿刺中心静脉导管 (PICC)与传统的经锁骨上或下静脉置管 (CVC)及普通留置针 3种化疗静脉通路的并发症发生情况。 方法 2 0 0 1年 2月～ 2 0 0 3年 6月 ,将 90例中晚期非小细胞肺癌患者 (NSCLC)随机分为 3组。分别应用 PICC导管通路、CVC置管通路和普通留置针 ,实施相同的化疗方案 (NP) ,比较 3种通路的优劣 ,予以 χ2检验。 结果 PICC置管组与 CVC置管组相比 ,PICC置管组无严重穿刺并发症 (气胸、血气胸、误穿动脉、大出血、感染 ) ,无中途脱管现象 ,导管留置时间较长 (P<0 .0 5)。 PICC置管在控制发生静脉炎和留置时间等方面明显优于普通静脉留置针组 ,无 1例发生药物外渗损伤。但 PICC组输液流速较慢 ,可能发生导管阻塞漂移及肺栓塞 ,是其潜在的缺点。 结论 在 NSCLC化疗静脉通路中 ,PICC置管并发症发生明显少于 CVC置管通路和普通留置针 ,利于保护血管 ,但其远期的安全性有待研究。
Object To study forwardly the complication occurring after three kind of chemotherapeutical vein path between PICC, CVC and common counterpart. Methods 2001.2-2003.6,90 cases with middle and later NSCLC were divided into 3 groups randomly, the same chemotherapeutical profile were applied with 3 different vein paths, the advantage and disadvantage of which were compared, the result were tested through χ 2 . Results The group using PICC had no severe puncture complication compared with the group using CVC, and former had the advantage of dislocation of catheter, long detain of catheter(P<0.05).The rate of occurring veinitis and time of catheter retain in PICC group is obviously lower than the normal group, no case of out infuse of liquid, but the PICC group has the disadvantage of slow dripping and the possibility of catheter obstruction and pulmonary embolism. Conclusion In NSCLC chemotherapy, there are fewer complications in PICC than those in CVC and common counterpart, which can protect vascular, but its long-term safety is deserved to explore.
关键词
NSCLC
化疗
静脉输液
导管
NSCLC
chemistry therapy
Intravenous injection
Catheter
