改良PICC预处理法预防化疗患者机械性静脉炎的效果

目的探讨改良外周置入中心静脉导管(peripherally inserted central catheter,PICC)预处理法预防化疗患者机械性静脉炎的效果。方法将2009年1月到2012年5月在常州市第二人民医院血液肿瘤科行PICC置管的130例化疗患者分为对照组和研究组各65例,对照组用传统的生理盐水100ml浸泡并冲洗导管,研究组用生理盐水100ml加地塞米松5mg、庆大霉素8万U混合液浸泡并冲洗导管,浸泡时间均为5min。比较两组置管患者机械性静脉炎及其他导管相关并发症的发生率。结果研究组机械性静脉炎的发生率(7.69%)低于对照组(20.00%),差异有统计学意义(χ2=4.13,P<0.05);两组局部渗血、导管阻塞和导管相关感染等其他并发症的发生率差异无统计学意义(均P>0.05)。结论改良PICC预处理法可以明显降低机械性静脉炎的发生率,而且不增加其他导管相关并发症的发生率,操作简单,使用安全,值得临床推广应用。

Effects of Modified Peripherally Inserted Central Venous Catheter Pretreatment on Preventing Mechanical Phlebitis in Patients with Chemotherapy

Objective To explore the effects of modified peripherally inserted central venous catheter （PICC） pretreatment on preventing mechanical phlebitis in patients with chemotherapy. Methods Totally 130 cases of chemotherapy patients with PICC were randomly divided into the experimental group and the control group, with 65 cases in each group. The control group used the 100 ml normal saline to rinse and soak the PICC catheter, while the experimental group used 100 ml normal saline mixed with 5 mg dexamethasone and 80 000U gentamicin to rinse and soak the PICC catheter. Difference of mechanical phlebitis and other complications were compared in these two groups. Results The incidence of mechanical phlebitis in control group （20%） was significantly higher than that in the experimental group （7.6N） （χ2 =4.13,P〈0.05）. No significant difference was found about other complications including local bleeding, obstruction of the catheter and catheter related infection between the two groups. Conclusion Modified PICC catheter pretreatment obviously decreased the frequency of mechanical phlebitis and did not increase other complications, which calls for further application.