摘要
目的 比较恶性肿瘤患者经锁骨下静脉和经周围静脉穿刺置入中心静脉导管发生血栓性导管堵塞的差异 ,探讨导管堵塞后应用尿激酶溶栓的安全性与有效性。方法 将 2 2 6例中心静脉置管的患者随机分为经锁骨下静脉组 (A组 ) 113例和经周围静脉组 (B组 ) 113例 ,按常规方法置管及进行导管护理 ,对发生导管堵塞者记录堵塞时间、尿激酶溶栓时间、溶栓效果。结果 A组发生导管堵塞 2 3人次 ,发生率 2 0 .4 % ,B组发生导管堵塞 5人次 ,发生率 4 .4 % ,总计 2 8例堵管发生的患者中有 2 7例溶栓成功 ,无一例发生不良反应。结论 肿瘤患者经周围静脉穿刺置入中心静脉导管发生导管堵塞的机会较经锁骨下静脉置入中心静脉导管低 ;尿激酶用于中心静脉导管堵塞后溶栓治疗是安全、有效的。
Objective To compare the difference of thromblotic catheter obstruction for inserting central venous catheters via subclavian vein and peripheral vein in malignant tumor patients, and determine whether urokinase could be used as a safe, effective alterntive to treat the occluded central venous catheters. Methods 226 patients requiring central venous catheterization were equally randomized into two groups: Group A, using centrally inserted subclavian catheterization, Group B, using peripherally inserted central catheter(PICC). To carry out inserting catheter and nursing in gengeral way, and record obstruction time, time of urokinase thrombosis and effect of thrombosis. Results There are 23 patients in group A have catherer obstruction, the occurent rate is 20.4%, there are 5 patients in group B have catherer obstruction, the occurent rate is 4.4%, and there are 27 cases of successful thrombosis among these 28 patients, and no one has adverse reaction. Conclusion Occlusions is more likely to happen in CVC group than in PICC group, and urokinase is a safe and effective thrombotic therapy for recanalization of occluded central venous catheters.
