摘要
目的探讨两种不同的封管方法在肿瘤患者行经外周置入中心静脉导管术(PICC)中的应用效果。方法选择2011年1月至2013年3月在我院行美国巴德单腔三向瓣膜式PICC的102例患者,按照随机数表法分为观察组和对照组各51例。对照组选择SAS法(S:生理盐水10 ml,A:给药,S:生理盐水10 ml);观察组采用SASH法(S:生理盐水10 ml,A:给药,S:生理盐水10 ml,H:50 U/ml肝素盐水10 ml)。置管两周后,比较两组患者的堵管情况和不良反应,并通过检测活化部分凝血活酶时间(APTT)和凝血酶原时间(PT)比较两种封管方法对患者血液指标的影响。结果对照组患者的堵管发生率为19.61%,而观察组仅为3.92%,差异具有统计学意义(P<0.05);对照组与观察组患者的血液指标APTT[(35.02±4.95)s、(33.98±8.95)s]和PT[(13.05±1.82)s、(13.35±1.02)s]都均在正常范围内,且两组比较差异无统计学意义(P>0.05)。两组患者在化疗期间均未出现血小板、粒细胞明显降低和出血倾向。结论肿瘤患者PICC置管行SASH封管法安全、效果好,可明显降低导管堵塞发生率、延长置管时间、减轻患者痛苦,值得临床推广应用。
Objective To investigate the effect of two tube-sealing methods for prevention of catheter blockage in cancer patients receiving peripherally inserted central catheters(PICC). Methods A total of 102 patients in our hospital from January 2011 to March 2013 undergoing bard single-cavity three-way valve PICC were randomly divided into experimental group(n=51) and control group(n=51). The control group(group A) was treated with the SAS method(S:physiological saline 10 ml, A: drug, S: physiological saline 10 ml), and the experimental group applied SASH method(S: physiological saline 10 ml, A: drug, S: physiological saline, H: 50 U/ml heparin saline). The blockage situation and adverse reactions were compared two weeks later, and the effect of the two methods were evaluated by detecting activated partial thromboplastin time(APTT) and prothrombin time(PT). Results There was statistically significant difference in the incidence of blockage between the two groups(P<0.05), with 19.61% in the control group and 3.92% in the experimental group. APTT [(35.02 ± 4.95) s in the control group,(33.98 ± 8.95) s in the experimental group] and PT[(13.05±1.82) s in the control group,(13.35±1.02) s in the experimental group] were all in the normal range, with no statistically significant difference between the two groups(P>0.05). There was no thrombocytopenia, granulocytopenia,bleeding in the two groups. Conclusion SASH method for sealing tube of PICC can effectively reduce the incidence of blockage, prolong the tube-indwelling time, reduce the pain of patients, with good safety and efficacy, which is worthy of clinical application.
出处
《海南医学》
CAS
2016年第5期851-853,共3页
Hainan Medical Journal
