儿童与成人急性白血病患者外周静脉留置中心静脉导管置管并发症的差异

目的:比较儿童与成年急性白血病患者外周静脉留置中心静脉导管(peripherally inserted central catheter,PICC)置管的并发症发生率,为不同类型患者提供更好的护理和治疗策略.方法:选取保定市第一医院52例儿童及100例成人急性白血病化疗行PICC置管患者,观察两组PICC置管后不同并发症及其发生率,探讨儿童与成人急性白血病PICC并发症的不同.结果:在儿童急性白血病PICC置管后出现并发症的总发生率为55.8％,显著高于成人急性白血病PICC置管后并发症总发生率的39.0％(x2=3.89,P＜0.05).其中感染发生率36.5％ vs.21.0％(x2=4.26,P＜0.05)、导管阻塞发生率23.1％ vs.11.0％(x2=3.89,P＜0.05);机械性静脉炎发生率19.2％ vs.5.0％(x2=7.79,P＜0.05).平均置管日儿童[(98.7±58.7)d]显著低于成人[(130.6±71.8)d](t=2.76,P＜0.01).非计划拔管率儿童为17.3％,显著高于成人的5.0％(x2=4.81,P＜0.05).结论:PICC置管后儿童与成人急性白血病患者各种并发症发生率及平均置管时间存在一定差异,可能与配合程度及年龄特点密切相关.

Difference of complications of peripherally inserted central catheters in children and adult acute leukemia patients

Objective:To compare the complication rate of peripherally inserted central catheters (PICC) in children and adult acute leukemia patients,and make a better application with treatment strategies in patients.Methods:Fifty two cases of children and 100 cases of adult acute leukemia patients were selected with PICC before chemotherapy.The incidence of the different complications of PICC with children and adult acute leukemia patients were observed.Results:The complication rate was 55.8％ in children acute leukemia after PICC,which was significantly higher than that of adult acute leukemia patients (39.0％,x2=3.89,P＜0.05).The incidence of infection rate was 36.5％ vs.21.0％ (x2=4.26,P＜0.05);the catheter occlusion rate was 23.1％ vs.11.0％ (x2=3.89,P＜0.05);the incidence of mechanical phlebitis was 19.2％ vs.5.0％ (x2=7.79,P＜0.05);the average tube indwelling day was 98.7±58.7 vs.130.6±71.8 (t=2.76,P＜0.01);the unplanned catheter removal rate was 17.3％ vs.5.0％ (x2=4.81,P＜0.05).Conclusion:The occurrence of complications and the average tube indwelling day between the children and adult acute leukemia patients after PICC are different,which may be associated with different cooperative degree and age characteristics.