[1]侯剑媚,张京慧,马梦丹,等.下肢不同血管通道在上腔静脉阻塞化疗患者中的应用[J].介入放射学杂志,2018,27(09):836-841.
 HOU Jianmei,ZHANG Jinghui,MA Mengdan,et al.Application of different vascular accesses of the lower extremity in chemotherapy for patients with superior vena cava obstruction[J].journal interventional radiology,2018,27(09):836-841.
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下肢不同血管通道在上腔静脉阻塞化疗患者中的应用()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
27
期数:
2018年09期
页码:
836-841
栏目:
肿瘤介入
出版日期:
2018-09-25

文章信息/Info

Title:
Application of different vascular accesses of the lower extremity in chemotherapy for patients with superior vena cava obstruction
作者:
侯剑媚 张京慧 马梦丹 徐彬斌 唐四元
Author(s):
HOU Jianmei ZHANG Jinghui MA Mengdan XU Bingbing TANG Siyuan
Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province 410008, China
关键词:
【关键词】 上腔静脉阻塞 化疗患者 股静脉置管 大腿中部股静脉 腹股沟股静脉 下肢留置针置管
文献标志码:
A
摘要:
【摘要】 目的 探讨下肢不同血管通道在上腔静脉阻塞患者中应用的优劣性,为上腔静脉阻塞化疗患者优选血管通路提供依据。方法 198例上腔静脉阻塞患者随机分为A、B、C 3组,分别接受经大腿中部股静脉置管、经腹股沟股静脉置管及下肢留置针置管,比较不同血管通道的应用效果及并发症发生率。结果 3组患者的一次性穿刺成功率(98.51%、98.48%、76.92%)、一次性置管成功率(98.51%、98.48%、76.92%)、疼痛评分(1.52±0.56、1.53±0.59、2.43±0.61)、出血量评分(2.48±0.64、2.59±0.55、3.65±0.54)、舒适度评分(4.06±0.60、1.39±0.58、1.38±0.58)、留置时间[(191.46±33.11) d、(96.62±32.46) d、(1.92±0.91) d]及操作时间[(30.28±3.45) min、(30.03±2.37) min、(3.29±0.46) min]比较,差异均有统计学意义(P<0.001)。3组患者的导管堵塞(7.46%、7.58%、12.31%)比较,差异无统计学意义(P>0.05)。3组患者的导管破损(1.49%、7.58%、0%)、导管血栓(1.49%、12.12%、7.69%)、导管感染(1.49%、18.18%、6.15%)、静脉炎(0%、0%、92.31%)及药物外渗(0%、0%、9.23%)发生率比较,差异均有统计学意义(P<0.05)。结论 经大腿中部股静脉PICC置管患者临床置管效果好,并发症低,患者舒适度强,留置时间长,在上腔静脉阻塞化疗患者中可作为优选静脉通道。

参考文献/References:

[1] Hohloch K, Bertram N, Trümper L, et al. Superior vena cava syndrome caused by a malignant tumor: a retrospective single- center analysis of 124 cases[J]. J Cancer Res Clin Oncol, 2014, 140: 2129- 2134.
[2] 陈石伟, 乔德林. 经皮上腔静脉成型术治疗上腔静脉阻塞综合征[J]. 介入放射学杂志, 2004, 13: 244- 246.
[3] 宋进华, 顾建平, 楼文胜, 等. 肺癌合并上腔静脉综合征的介入治疗[J]. 介入放射学杂志, 2008, 17: 182- 185.
[4] 俞雪芳. 上腔静脉阻塞综合征患者输液技术的探讨和护理[J].临床肺科杂志, 2008, 13: 672.
[5] Peus D, Newcomb N, Hofer S. Appraisal of the Karnofsky Performance Status and proposal of a simple algorithmic system for its evaluation[J]. BMC Med Inform Decis Mak, 2013, 13: 72.
[6] 王曙红. 临床护理评价量表及应用[M]. 长沙: 湖南科学技术出版社, 2011: 200- 211.
[7] Zhang J, Tang S, Hu C, et al. Femorally inserted central venous catheter in patients with superior vena cava obstruction: choice of the optimal exit site[J]. J Vasc Access, 2017, 18: 82- 88.
[8] Meissner MH. Lower extremity venous anatomy[J]. Semin Intervent Radiol, 2005, 22: 147- 156.
[9] 贺连香, 张京慧, 高红梅. 静脉治疗护理操作技术与管理[M]. 长沙: 中南大学出版社, 2014: 195- 264.
[10] Frykholm P, Pikwer A, Hammarskjold F, et al. Clinical guidelines on central venous catheterisation. Swedish Society of Anaesthesiology and Intensive Care Medicine[J]. Acta Anaesthesiol Scand, 2014, 58: 508- 524.
[11] Pittiruti M, La Greca A, Scoppettuolo G. The electrocardiographic method for positioning the tip of central venous catheters[J]. J Vasc Access, 2011, 12: 280- 291.
[12] Larragoiti- Correa E, Rendon- Macias ME. Parental perception of their child’s pain tolerance and abdominal postoperative analgesic requirements[J]. Rev Med Inst Mex Seguro Soc, 2013, 51: 284- 291.
[13] 张京慧, 李雪兵, 贺连香, 等. 肺癌合并上腔静脉梗阻患者股静脉留置PICC导管的研究[J]. 中华护理杂志, 2015, 50: 692- 696.
[14] Gorski LA. The 2016 infusion therapy standards of practice[J]. Home Healthc Now, 2017, 35: 10- 18.
[15] 张京慧, 唐四元, 贺连香, 等. PICC规范化培训与管理对临床置管效果及并发症的观察[J]. 中南大学学报?医学版, 2014, 39: 638- 643.
[16] Pittiruti M, Emoli A, Porta P, et al. A prospective, randomized comparison of three different types of valved and non- valved peripherally inserted central catheters[J]. J Vasc Access, 2014, 15: 519- 523.
[17] 中华人民共和国国家卫生和计划生育委员会.静脉治疗护理技术操作规范[J]. 中国护理管理, 2014, 14: 1- 4.
[18] Vezzani A, Manca T, Vercelli A, et al. Ultrasonography as a guide during vascular access procedures and in the diagnosis of complications[J]. J Ultrasound, 2013, 16: 161- 170.
[19] Airapetian N, Maizel J, Langelle F, et al. Ultrasound- guided central venous cannulation is superior to quick- look ultrasound and landmark methods among inexperienced operators: a prospective randomized study[J]. Intensive Care Med, 2013, 39: 1938- 1944.
[20] American Society of Anesthesiologists Task Force on Central Venous Access, Rupp SM, Apfelbaum JL, et al. Practice guidelines for central venous access: a report by the American Society of Anesthesiologists Task Force on Central Venous Access[J]. Anesthesiology, 2012, 116: 539- 573.
[21] Alten JA, Borasino S, Gurley WQ, et al. Ultrasound- guided femoral vein catheterization in neonates with cardiac disease[J]. Pediatr Crit Care Med, 2012, 13: 654- 659.
[22] 熊 斌, 王 奇, 郑传胜, 等. 经股静脉入路套取中心静脉导管体内断管五例经验[J]. 介入放射学杂志, 2013, 22: 501- 504.

备注/Memo

备注/Memo:
(收稿日期:2018-03-22)
(本文编辑:俞瑞纲)
更新日期/Last Update: 2018-09-11