三种途径中心静脉置管化疗并发症比较护理研究

目的 对进展期的乳腺癌和胃肠道癌化疗期间采用三种中心静脉置管(CVC)比较护理研究,以探讨和选择化疗药物输入的最佳护理途径.方法 选取进展期乳腺癌和胃肠道癌患者86例,分别经颈内静脉(IJVA)、外周静脉(PICC)和锁骨下静脉(SVADDS)导入CVC.其中IJVA 21例,PICC43例,SVADDS 22例.结果 IJVA、PICC和SVADDS三组并发症总发生率分别为19.0%、74.4%和18.2%,因导管阻塞和感染等并发症而拔管的发生率分别为19.0%、44.2%和4.5%.三组间比较,差异有统计学意义(P＜0.01).结论 在三种途径的CVC比较中,IJVA置入虽然方便,缺点是每次化疗前需要进行穿刺置管;PICC管则并发症多;而SVADDS具有并发症少、提高患者生活质量和可以长期保留等优点,SVADDS是患者化疗置管的最佳途径.

Abstract：

Objective To compare and study the complications of the central venous catheterizations(CVC) via three accesses in advanced tumors of breast and gastrointestinal tract during chemotherapy to acquire the best liquid path of chemotherapeutic drugs.Methods A total of 86 breast cancer and gastrointestinal cancer patients were selected randomly who were treated with different central venous catheterizations (CVC) .Among of them 21 cases were treated by means of internal jugular venous access (IJVA), 43 cases were treated by means of peripherally inserted central catheter (PICC) and 22 cases were treated by means of subclavian vein drug delivery system (SVADDS) .Results The total incidence rates d complications for IJVA, PICC, SVADDS group were 19.0%, 74.4%, 18.2% respectively (P ＜ 0.01 ) .The incidence rates of extubation because of infections and embolisms for these three groups were 19.0%,44.2%, 4.5% respectively (P＜0.01) .Conclusions The method of IJVA is convenient.But percutaneous catheter is wanted before chemotherapy.So many complications exist in PICC group..Relatively SVADDS is the best intravenous method of chemotherapy for few complications, a long duration and a better comfort.

Comparative study of complications of chemotherapy by three central venous catheterizations

Objective To compare and study the complications of the central venous catheterizations(CVC) via three accesses in advanced tumors of breast and gastrointestinal tract during chemotherapy to acquire the best liquid path of chemotherapeutic drugs.Methods A total of 86 breast cancer and gastrointestinal cancer patients were selected randomly who were treated with different central venous catheterizations (CVC) .Among of them 21 cases were treated by means of internal jugular venous access (IJVA), 43 cases were treated by means of peripherally inserted central catheter (PICC) and 22 cases were treated by means of subclavian vein drug delivery system (SVADDS) .Results The total incidence rates d complications for IJVA, PICC, SVADDS group were 19.0%, 74.4%, 18.2% respectively (P ＜ 0.01 ) .The incidence rates of extubation because of infections and embolisms for these three groups were 19.0%,44.2%, 4.5% respectively (P＜0.01) .Conclusions The method of IJVA is convenient.But percutaneous catheter is wanted before chemotherapy.So many complications exist in PICC group..Relatively SVADDS is the best intravenous method of chemotherapy for few complications, a long duration and a better comfort.