2014 12 22 6 381 @ABCDE FGHAIJKL 林伟芬杨西宁李赛梅黄显实卢耀振陆小萍农美英陈海丽 M KLNOFGHA FGHA O FGHB F GPA (PICC) QRFGHASTU,VW %XSY FGHA C 2007 12 2013 4 275 M.Z FGHAS [Z\]^_`,aNOF GHA 38 FGHA 96 PICC106 QRFGHA 35,KL 4 bchaijs HA HA HA PA HA 4 FG HA HA Q HA (P= 0 595); HA (P=0 000), PA H (P=0 000) KL,PICC HA 2 NOFG FG QRF G (P=0 004,P=0 003,P=0 006), PA H 2 a 3 (P=0 001,P= 0 000,P=0 002) HA QPA H S (P=0 002); 4 bc FGHAIJ ^ (r=0 318,P=0 000) 4 FGHA, S Sbc S FGHAIJ NOFGHA; FGHA;RFGHA; O FGHB FGPA R143 73!"#$ A %& 1674 635X(2014)06 0381 06 Comparisonoffourmethodsofdeep veincatheterinsertioninlungcancerpatients LinWeifen,Yang Xining,LiSaimei,HuangXianshi,LuYaozhen,LuXiaoping,NongMeiying,ChenHaili. Departmentof Oncology,MinzuHospitalofGuangxiZhuangAutonomousRegion,Nanning530001,China Corespondingauthor:YangXining,DepartmentofNursing,MinzuHospitalofGuangxiZhuangAutonomous Region,Nanning530001,China,E mail:1225348205@qq.com Abstract Objective Toinvestigatetheoptimalmethodofcatheterizationforlungcancerpatientsby comparingexternaljugularveincatheter,subclavianveincatheter,peripheralyinsertedcentralcatheter (PICC)andfemoralveincatheter.Methods 275lungcancerpatientstreatedwiththe4typesofcatheter izationwereselectedforthisretrospectivereviewfromdecember2007toapril2013,including38whowere insertedwithexternaljugularveincatheter,96withsubclavianveincatheter,106withpicc,and35with femoralveincatheter.succesrate(one timeandtotal),meancatheterizationtime,meancatheterindwel ingtime,incidencesofcatheter relatedcomplications,andpatientcomfortofthe4groupswerecompared. Results Thesuccesratesofthe4groupswerenotsignificantlydiferent(P=0 595);meancatheterization timeandcatheterindwelingtimeweresignificantlydiferent(bothp=0 000).Themeancatheterization timeinthepiccgroupwassignificantlyshorterthanthoseintheexternaljugularveingroup,subclavianvein groupandthefemoralveingroup(p=0 004,P=0 003,P=0 006),andthemeancatheterindweling timewassignificantlylongerthanintheother3groups(p=0 001,P=0 000,P=0 002).Totalinci denceofcomplicationsduringcatheterizationandcatheterindwelingwassignificantlydiferentamongthe4 groups(p=0 002);patientcomfortwasfoundcorelatedwithcatheterizationmethod(r=0 318,P= 0 000).Conclusions The4typesofdeep veincatheterizationarealmaturetechniqueswithhighsucces DOI:10.3760/cma.j.isn.1674 635X.2014.06.012 :!"#$%&' (Z2011415) ():530001*+,!,#-./0 (1 23 456 789 :; ), < (=!+) >? :=!+,E mail:1225348205@qq.com
382 2014 12 22 6 rates.themostappropriatecatheterizationmethodshouldbedecidedbasedonindividualconditionsofeach lungcancerpatient. Keywords Externaljugularveincatheter;Subclavianveincatheter;Femoralveincatheter;Periphe ralyinsertedcentralcatheter %X XQ X ^/0S 3 % XI [1] M ^/0 2), %X S 3 % XI,a X > F G C X ^, FGHA /0 3 X b SFG C \]KL M _ 4 FGHAIJ [NOFGHA FG HA RFGHA O FGHB FGP A (peripheralyinserted centralcatheter, PICC)] STU, X Y HAI J P 1 ' 1 1 2007 12 2013 4 M!,# -. FGHA HAS 275, S Q%XI, b chaij NOFGHA 38,a^ 30 ^ 8,) 56; FG HA 96,a^ 68 ^ 28,) 54;R F G H A 35,a ^ 26 ^ 9,) 57;PICC 106, a^ 82 ^ 24,) 53 (P=0 782) B 1 2 HAI NOFGHA FGHA RFGH A ; ARROW S ( FGPA ( 20cm,A 0 33ml),PICC ;! " S 4Fr# $ % & J PICC ( 60cm) FG' S M- P 1 2 1 NOFGHA,() 15 ~30,(<*$ +,$ -./,01, <, 234NOFG56, 78 9:;S 1/3 NOFGO-+ Ma2[, ( 45,B <= 25,>\@ <?[ 2~3mm,@BPA,BC',DP A?HBPA 14~16cm E\@> <,PA FGA,' 9 PA H;IJ,? 10cm 12cmKLMNIJ,O< X;, 1 2 2 FGHA, < 8,(P$' -,QR./,01, 5mlSTUE 2%VWXY 5ml < V@A,[ 30 ~40, $ O 2 +, Z[ ZE\@,V[[ I$ 8, \[ 2 5~4cm] ^_ FG, V <? ' c` V I$[, \@<@BPA,BC' PA@[abU,a < PA@[PA,PA HB c- 12~15cm, - 15~18cm, CPA,GAIJ 1 2 3 RFGHA ),' - O O,,QR./, M R I< R G YL2<), 5ml STUE 2%VWXY 2mlMR G -0 5cm [, 30 ~45, < V@ A,[ 2~5cm,Z[ ZE\@,V[[ I $ 8, V < ' VI$[, \@<@BPA,BC' PA@[abU,a < PA@[PA,HA 18~20cm,GAIJ 1 2 4 PICCHA ),' 9 FG F G (FG, ' - O 90, [ ' 9_O <$ # PA,QR./,,, PA, 0 %X1,0 1, @,? FG $,c ', $2, 15 ~20 [,>\@<?[,@' 1~
2014 12 22 6 383 2cm, C',c (P$' -,c @BPA [, CP A, CPA,90 PA, : U,E\@> < FGA 1 3 1 3 1 HA HA 1 [ >@ 3 S V[@A ; HA [ 9 ' 3 2 V[@A [2] HA<O< X; 3PA )HM2FG 1/3 c S: [3],EC\@, > HA b HA 1 3 2 HA H HA U, ' PA H PAHB A 1 3 3 \], 4 HA H A S (1) O:' O&,C,O< X; O, C (2) G:' \@ $ \@,@BPA< \@,\@ (3) @A :MHA @A, PA HB, Y,PA( _^ S@A)Hb[ Bc [4] (4) PA ): 2FG @A Y, 3PA FG N FG OO-FG [5] (5) ^ FG!: ; FG! "S_# [6],0# $;1# <%&,/ '/,FG $=, ;2# < %&,/ '/,FG $=, ;3# <%&,/ '/,FG $=, (6) < :' <) ( )C, * + ^, (- 3.! S / ) [7],_0 1 3 (7) @ : C /, &,Z@A B2 3 @ [8] (8) PA3C: PAI Jb4, 5 67NM,8 9 b8 PA C [9] 1 3 4 $Z: ; /, HA S b ' 9%& ' - %& <b =>? @A 9 BC 10 ; D E _, ; D 1_, _ 10_ 1~4_ b,5~7_ b,8~10 _ b [10] 1 4 SPSS12 0 [Z_` I _`,I t,i b [Z S t, KL q ; χ 2,P<0 05 2 2 1 HA QPA H 4 S FGS HA (F=19 88,P=0 000), PA H (F=92 79,P=0 000) (/ 1) KL,PICC HA 2 NOFG FG QRFG (q= 5 993,P=0 004; q=6 744, P =0 003; q= 7 785,P=0 006), PA H 2 a 3 (q=16 003,P=0 001;q=21 015, P=0 000;q=13 729,P=0 002) NOFG FG QRFG KL (P >0 05) 1 NOFG FG RFGQ PICC HA Q PA H KL Table1 Meancatheterizationtimeandcatheterindweling timeintheexternaljugularveincatheter,subclavian veincatheter,femoralveincatheter,andpiccgroups HA (x±s,min) PA H (x±s,d) Y PA H ( ) NOFG 18 02±11 60 19 06± 7 30 1 0 (n=38) FG 17 06± 6 40 22 02± 18 60 3 5 (n=96) RFG 20 04± 4 80 35 08± 6 40 6 3 (n=35) PICC (n=106) 12 07± 7 10 158 03±102 70 11 3 FF 19 88 92 79 PF 0 000 0 000
384 2014 12 22 6 2 2 HA 4 HA HA Q HA (χ 2 =1 895, P = 0 595)(/ 2) 2 3 4 M' GS (P=0 148), O PA ) @A S (P <0 05);P A H < FG@ PA3C FG! S (P < 0 05),HA QPA H (P=0 002)(/ 3) 2 4 4 bc FGHAIJ ^ (r=0 318,P=0 000) FG b K Y (98 95%),NOFG b K Y (16 3%)(/ 4) 3 U2,PICCHA ag 3 HAIJ,MHA 2 L2HI J K(, MLL [Z FG' 6, MS ML S 2 4 HA KL [n(%)] Table2 Succesrateofcatheterizationinthe4groups[n(%)] HA HA HA NOFG (n=38) 35(92 10) 3(7 89) 38(100) FG (n=96) 92(95 83) 4(4 16) 96(100) RFG (n=35) 33(94 28) 2(5 72) 35(100) PICC (n=106) 103(97 16) 3(2 84) 106(100) χ 2 F 1 895 PF 0 595 3 4 HA KL [n(%)] Table3 Catheter relatedcomplicationsinthe4groups[n(%)] O G PA ) @A NOFG (n=38) 0 0 0 3(7 89) FG (n=96) 2(2 08) 3(3 12) 5(5 20) 0 RFG (n=35) 1(2 85) 0 0 1(2 85) PICC (n=106) 13(12 26) 0 0 8(7 54) N (Cramer sv) 0 221 0 142 0 176 0 174 PF 0 004 0 148 0 028 0 041 < FG@ PA3C ^FG! NOFG (n=38) 1(2 63) 0 6(15 78) 0 11(28 94) FG (n=96) 6(6 25) 0 2(2 08) 0 18(18 75) RFG (n=35) 12(34 28) 3(8 57) 2(5 71) 0 18(51 42) PICC (n=106) 3(2 85) 5(4 71) 2(1 88) 14(13 20) 37(34 90) N (Cramer V) 0 375 0 183 0 232 0 292 0 230 PF 0 000 0 027 0 002 0 000 0 002 4 PAHAQPA H KL [n(%)] Table4 Degreesofcomfortinpatientsduringcatheterizationandcatheterindweling[n(%)] b b b NOFG (n=38) 25(65 28) 7(18 42) 6(16 3) FG (n=96) 95(98 95) 1(1 05) 0 RFG (n=35) 30(85 71) 3(8 57) 2(5 79) PICC (n=106) 102(96 22) 3(2 83) 1(0 95) χ 2 F PF 45 690 0 000
2014 12 22 6 385 HA,NOFGQRFG' O % XI Q S, L, HA L SY PICC PA H Y,^ (158 03±102 7) d, ; FG " (InfusionNursesSociety,INS) S PICC H (48h~1) [11] 4 SHA 100%, HA M 90% 2, L 4 FGHA' L S NOFGHAQ PICCHA @A [3/38(7 89%),8/106(7 54%)], F G )HQ <b FGHAQ PICCHA C PA ),a FGPA ) ' C ), PA BN F G;PICCP ) N FG FG - FG, PA \ FG FG QRFGHA C G, FGQR FG G Q ZS )H [12] FGHA O, FGRSO&,T' UO&, V O @O HA S ' W FGS )H XQ Y,Y J ', HAFG S Z,[\ S >]^,_` <b a ' HA S b MPA H, 4c FGHA C ' <) <, Y S RFGHA,Y RFGS" <, B), J, S,YJ NO< K [13], RFG' HB FGPAS ^ 47 3% [14], 34 28%, M FGHAS 6 FG 3 M, A N<C W,, 3 HA<Y Z A, 2 U, _`MQS M S)H[Z FGHA,HA< SC M A= ag<)ha [15],QRHAIJ 2 / FG! S 20%, ^FG! 13 20%, HA [Z E HAQH A<][Z PICCHA Q RFGHA C FG@,RFGHA @ S Y 2FG @ $, 2 C 9 L, @ PICCHA<C SFG@ P PAM@A C @A8 PAX b, X PAS@, Pinon [16] S YJM S, 8X SPA,. ^\ SPA, PA, PA,b @ [17] PA3C PA C S,PA H HA-S-O N< 2 _` 9, _` a PA* ), PA3C KL 4 HAIJ,NOFG' [18],, [19], [ FG ^, 3,MN< ;, ), b B FGH A [ FG ^,b 3,b ;,,' 6,HA C PICCMLL, ^,,IJ4R,b 3, L, PA H LW RFGHA',' 6 ), Q@, 6, a RFGHA %XTUY\, Q [ FG,YJNOFG FGHA ; S X \ 6~ 8cX,PICC H Y, K(, XS ;M 2 P F G L L S,N O F G H A PICC' S I [18] ; FG' H A XS [20] 65%S2F G [21], </0 C 2FG,RFGHA J B XS FG C 2, KLS 4 FGHAI S HA,a PICCSHA L PA H L 4 HA S b c, HAIJ, S bc S FGHAI! [1] =. FGHA M XS [J].
386 2014 12 22 6 -.,2006,27(12):1495 1496. [2],,.PICC A FG AM @ S KL [J],,2003,38 (1):31 33. [3]. %X 3 * 3 P [M]. :, -C,2011:21 30. [4]. O AS FGPA (PICC) HA S Y_`Q [J]. -,2005,29(2):133 134. [5] 9,,.PICCBA SY_` [J].,2009,16(19):71 72. [6],.O FGPA A [M]. :, -C,2010:122 161. [7] b,. FGPA ^ S Y _` [J]. 3,2012,9(14):127 128. [8].PICC HA S [J].,2009,29(8):1012 1014. [9],!,b"#. AC.< S Y_` [J].,2008,15(10):80 81. [10] 9, $%,& ',. MZ PICC S [J].,2012,18(12):73 74. [11] InfusionNursesSociety.InfusionNursingStandardsofPractice [J].JInfusNurs,2006,29(1Supp1):S1 S92. [12]. FG' HA BFG SI [J].3,2002,18(1):46 [13],()*.@A PA S@Z [J]. -,2005,30(1):82 84. [14] +. FGPA ^ S [ [J].,2009,15(15):41 43. [15],,,- 1,.' PICCHA S I [J].3,2003,19(7):5 6. [16] PinonM,BezioS,TovoPA,etal.Aprospective7 yearsurvey oncentralvenouscatheter relatedcomplicationsatasinglepediatric hospital[j].eurjpediatr,2009,168(12):1505 1512. [17].. FGPA ^ S [ [J].2,2013,13(1):54 57. [18] /, 0,1,,/0 bc C O ' FGHASKL [J].,2010,17 (9B): 62 63. [19],, 1,,NOFG' HAM S [J]. 2-.2010,48(31): 61 62. [20] H3,& 4, 5,.PICC FGHAM /0 XS TUKL [J].,2007, 22(8):13 14. [21] b 6,7 8./0. 9 [M]. :; C,1996:2605. ( ; :2014 04 08)