化疗期锁骨下中心静脉置管并发症的早期干预

目的 探讨肿瘤患者锁骨下中心静脉置管并发症的原因及防护措施。方法 总结2002年9月-2006年10月间为肿瘤内科患者行锁骨下中心静脉置管术320例，观察和记录各种并发症的发生，分析其原因及护理注意事项。结果 出现并发症36例，发生率为11．2％，其中气胸4例，误伤动脉3例，臂丛神经损伤2例，感染8例，导管脱落4例，导管堵塞12例，静脉血栓3例。经密切观察，及时发现，加强护理，均顺利恢复并完成治疗。结论 熟练掌握锁骨下中心静脉置管操作技能，严格把握禁忌证，建立持续监测系统，促进质量改善，实施全面的健康教育，可以大大降低中心静脉置管患者并发症的发生率。

Observation and Nursing Strategies of Complications of the Central Venous Catheter by Percutaneous Subclavian Venipuncture for Patients with Cancer

Objective To investigate the reasons of complications and preventions of the central venous catheters by pereutaneous subclavian venipuncture for patients with cancer. Methods From 2002 September to 2006 July, 320 patients with cancer in medical oncology department were performed subclavian vein catherization, the complications were detected and recorded, the reasons and the nursing were analyzed at the same time. Resuits The complications were observed in 36 patients of the total group with a complication rate of 11. 2%, including 4 cases with pneumothorax, 3 cases with subclavian aterial perforation, 2 cases with injury of brachia plexus nerve, 8 cases with catheters - related infection, 4 cases with catheter migration, 12 cases with catheter obstruction and 3 cases with venous thrombosis. Through careful observation, discovery on time and strengthening nursing, all the complications were treated satisfactorily and all the patients were completed treated as schedule. Conclusion Skillfully mastering the technics of central venous catheter by subclavian venipuncture, continuous observation and performing all - around health education may distinctly decrease its complication rates and improve the quality of life of patient with cancer.