摘要
目的探讨植入式静脉输液港(VAP)与经外周静脉穿刺中心静脉置管(PICC)在高龄患者长期应用效果。方法选择2008年3月—2013年6月厦门大学附属中山医院干部病房需长期输液的高龄患者53例,采用随机数字表法将患者随机分两组:VAP组23例,PICC组30例,分别统计两组患者导管留置率、意外拔管率及导管堵塞、导管渗漏、导管尖端异位、导管相关性血流感染的发生率。结果置管后第1个月两组导管留置率比较,差异无统计学意义(P>0.05);置管后第3个月、第6个月及12个月以上,VAP组导管留置率较PICC组增高(P<0.05)。VAP组意外拔管率较PICC组低(P<0.05)。VAP组1例发生导管堵塞,未发生导管渗漏情况,1例出现导管尖端异位,1例发生导管相关性血流感染;PICC组9例发生导管堵塞,4例发生导管渗漏,3例出现导管尖端异位,2例因导管相关性血流感染而拔管。VAP组导管堵塞发生率较PICC组低(P<0.05);而两组导管渗漏、导管尖端异位、导管相关性血流感染发生率比较,差异均无统计学意义(P>0.05)。结论 VAP比PICC的留置时间长,意外拔管和导管堵塞发生率低,更适合作为高龄患者长期静脉输液的通路。
Objective To explore the long - term application effect of the implantable venous access port （VAP） and peripherally inserted central catheters （PICC） in older patients. Methods A total of 53 older patients who needed long - term intravenous infusion therapy were recruited from department of cadre ward, Zhongshan hospital affiliated to Xiamen university from March 2008 to June 2013, the patients were randomly divided into 2 groups, 23 cases in VAP group and 30 cases in PICC group. The rate of catheter indwelling and accidental catheter extubation, incidence of catheter obstruction, catheter leakage, the catheter tip dystopy and catheter - related bloodstream infection in both groups were analyzed. Results There was no significant difference in catheter indwelling rate between two groups 1 month after intubation （P 〉 0. 05 ）, but 3 months, 6 months or longer than 12 months after intubation, catheter indwelling rate of VAP group was significantly higher than that of PICC group （P 〈 0.05 ） . The accidental catheter extubation rate of VAP group was significantly lower than that of PICC group （ P 〈 0.05 ） . In VAP group, catheter obstruction occurred in 1 case, catheter tip dystopy occurred in 1 case, catheter - related bloodstream in- fection occurred in 1 case, catheter leakage was not found in all cases. In PICC group, catheter obstruction occurred in 9 cases, catheter leakage occurred in 4 cases, catheter tip dystopy occurred in 3 cases, catheter - related bloodstream infection occurred in 2 cases and led to tube drawing. The rate of catheter obstruction in VAP group was significantly lower than that in PICC groups （P 〈0. 05） . There was no significant difference in rate of catheter leakage, catheter tip dystopy and catheter - related blood- stream infection between two groups （P 〉 0. 05） . Conclusion The indwelling time of VAP is longer than that of PICC, inci- dences of accidental catheter extubation and catheter obstruction are low, VAP is more suitable for senile patients with long - term intravenous infusion pathways.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第3期331-333,共3页
Chinese General Practice
