摘要
目的比较肝素、枸橼酸钠及尿激酶封管液对血滤患者中心静脉导管封管的有效性及安全性。方法选择2016年5~10月首都医科大学附属北京友谊医院重症医学科收治的留置中心静脉导管进行血滤治疗的患者60例。采用随机数字表法将其随机分成三组,每组各20例。A组采用肝素钠溶液封管,B组采用枸橼酸钠封管,C组采用尿激酶溶液封管。观察并比较三组患者中心静脉置管后21 d的有效性(包括导管堵塞、导管功能不良)和安全性(包括消化道出血、药物过敏、导管相关性感染、低钙血症、穿刺点周围渗血或皮下血肿发生率)。结果 60例患者中,导管功能不良(61.67%)、穿刺点周围渗血或皮下血肿(58.33%)发生率较高,药物过敏、导管堵塞、导管相关性感染、消化道出血、低钙血症发生率均较低(均<5.00%)。三组患者导管功能不良发生率、穿刺点周围渗血或皮下血肿发生率比较,差异均有统计学意义(P<0.05)。B、C组导管功能不良发生率低于A组,差异均有统计学意义(P<0.05)。B组穿刺点周围渗血或皮下血肿发生率低于A、C组,差异均有统计学意义(P<0.05)。结论枸橼酸钠封管在血滤患者中心静脉导管中更安全、有效,值得临床广泛应用。
Objective To compare the effectiveness and safety of tube-sealing fluids of Sodium Heparin, Sodium Citrate and Urokinase for the tube-sealing of central venous catheters in patients with hemofihration. Methods Sixty hemofihration patients with central venous catheters admitted to Department of Critical Care Medicine, Beijing Friend-ship Hospital, Capital Medical University from May to October 2016 were selected, and they were divided into three groups by random table number, with 20 cases in each group. Group A was given Sodium Heparin to seal tube, group B was given Sodium Citrate to seal tube, group C was given Urokinase to seal tube. The effectiveness （including catheter jam, catheter dysfunction） and safety （including the incidence of gastrointestinal bleeding, drug allergy, catheter-related infection, hypocalcemia, errhysis around puncture point or subcutaneous hematoma） of the three groups after central vena catheterization for 21 d were compared. Results Among 60 patients, the incidence of catheter dysfunction （61.67%）, er rhysis around puncture point or subcutaneous hematoma （58.33%） was high and the incidence of drug allergy, catheter jam, catheter-related infection, gastrointestinal bleeding and hypocalcemia was low （〈5.00%）. There were statistically significant differences in the incidence of catheter dysfunction and errhysis around puncture point or subcutaneous hematoma among the three groups （P 〈 0.05）. The incidence of catheter dysfunction in the group B and C was lower than that of group A, with statistically significant differences （P 〈 0.05）. The incidence of errhysis around puncture point or subcutaneous hematoma in the group B was lower than those of group A and C, with statistically significant differences （P 〈 0.05）. Conclusion The tube-sealing of Sodium Citrate in central venous catheters of patients with hemofihration is more safe and effective, which is worthy of clinical popularization.
作者
金艳鸿
尹璐
JIN Yanhong YIN Lu(Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China)
出处
《中国医药导报》
CAS
2017年第28期178-180,F0003,共4页
China Medical Herald
基金
首都医科大学附属北京友谊医院科研启动基金资助项目(yyqdkt2016-hl3)
关键词
枸橼酸钠
肝素
尿激酶
中心静脉导管
封管液
Sodium Citrate
Heparin
Urokinase
Central venous catheter
Tube-sealing fluids
