经外周静脉置入中心静脉导管与中心静脉置管在外科营养中的应用

目的 探讨经外周静脉置入中心静脉导管( PICC)与中心静脉置管(CVC)在外科肠外营养中的应用.方法 回顾性分析PICC与CVC的置管用时、置管成功率、导管留置时间、穿刺异常及不良反应.结果 CVC组置管操作平均时间(28.67±5.13) min短于PICC组的(45.20±6.89) min (P=0.035)；PICC组平均导管留置时间(114.85±10.29)d长于CVC组的(24.78±8.42)d(P=0.033)；PICC组与CVC组的置管成功率比较差异无统计学意义(P＞0.05)；PICC组优于CVC组的并发症有5项,而CVC组优于PICC组的并发症仅为静脉炎.结论 对于长期营养(＞4周)的患者提倡使用PICC,护理管理者应着眼于PICC技术的培训与发展；而CVC具有置管操作时间短、流速快的优点,更适合于重症急诊患者的抢救治疗.

Application of peripherally inserted central venous catheter and central venous catheter in the surgical nutrition

Objective To explore the application of peripherally inserted central venous catheter (PICC)and central venous catheter (CVC) in the surgical parenteral nutrition.Method The operation time,success rate,indwelling duration,abnormal biopsy,and adverse reactions of PICC and CVC were retrospectively compared.Results CVC had significantly shorter operation time than PICC groups [ (28.67 ±5.13) min vs.(45.20 ±6.89)min,P =0.035 ).The mean indwelling duration was significantly longer in PICC group than in CVC group [ ( 114.85 ± 10.29) d vs.(24.78 ± 8.42) d,P =0.033 ].PICC group was superior to CVC group in terms of five complication items,while only phlebitis was more frequent/severe in CVC group.Conclusions PICC may be more suitable for long-term ( ＞4 weeks) catheter-based nutrition.CVC has short operation time and fast flow rate,and therefore is most suitable for rescue treatment for critically ill patients.