摘要
目的比较不同深静脉置管方式在重症监护病房(ICU)危重患者中的应用效果,为深静脉置管的合理应用提供临床依据。方法选取ICU 2010年1月至2011年12月深静脉置管患者125例,对其采用颈内静脉置管(75例)、锁骨下静脉置管(25例)、股静脉置管(9例)、经外周穿刺中心静脉导管(PICC,16例)方式置管,并进行常规护理及并发症的观察对比。结果 4种不同置管方式导管留置时间比较,差异有统计学意义(F=4.501,P<0.01),其中PICC置管组导管留置时间较颈内静脉置管组、锁骨下静脉置管组显著延长,差异有统计学意义(P<0.01);股静脉置管组并发症发生率较颈内静脉置管组、锁骨下静脉置管组及PICC置管组高,差异有统计学意义(χ2=4.858、6.048、8.466,P=0.028、0.014、0.004),其中股静脉置管组发生率最高,颈内静脉置管组次之,PICC置管组最低。结论 4种置管方式各有利弊,在临床上可以互补,应根据患者具体情况来选择。在无禁忌证和血管条件许可的情况下,建议首选PICC置管。
Objective To compare the effect of different sites of intravenous catheterization in critical patients in inten sive care unit（ICU＇） and provide clinical basis for the reasonable application of the deep intravenous catheterizaiton. Methods A total of 125 patients with intravenous catheterization selected from ICU from January 2010 to December 2011 were with internal jugular intravenous catheterization （n=75）, subclavian intravenous catheterization （n=25）, femoral intravenous catheterization （n= 9） and periperally inserted central catheter（PICC, n=16） under routine nursing and to observe and analyze the complications. Results There was a statistically significant difference in catheter retention time among four ways （F=4.501, P〈0.01 ）, and catheter retention time in PICC group prolonged obviously than that in jugular vein catheter group and the subclavian vein group with sta tistically significant difference （P〈0.01 ） ;the complication rate in the femoral intravenous catheterization group was higher than that in internal jugular intravenous catheterization group, subclavian intravenous catheterization group and PICC group with statistical ly significant difference （.~=4.858,6.048,8.466; P=0.028,0.014,0.004 ）, and the top one was femoral intravenous catheterization, followed by internal jugular intravenous catheterization and PICC was the lowest. Conclusion There are advantages and disad- vantages in the four ways, and they can complement each other clinically. The way should be ehosed in light of patientsl condition. The PICC is the first choice in case of non-contraindications and vascular conditions permit.
出处
《现代医药卫生》
2013年第18期2739-2740,共2页
Journal of Modern Medicine & Health
关键词
穿刺术
护理
导管
留置
静脉
重症监护病房
深静脉置管
Punctures/nursing
Catheters,indwelling
Veins
Intensive care units
Deep venous catheter
