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|本期目录/Table of Contents|

三种中心静脉置管路径的比较

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2013年第4期
页码:
450-453
栏目:
临床研究
出版日期:
2013-07-25

文章信息/Info

Title:
A comparative study of three different accesses for central venous catheterization
作者:
祝 鹏; 谢 静; 任 晖; 李 静; 刘胜强; 郑时康; 王甲文
(安康市中心医院心内科，陕西 安康 725000)
Author(s):
ZHU Peng;  XIE Jing;  REN Hui;  LI Jing;  LIU Shengqiang;  ZHEN Shikang;  WANG Jiawen
(Department of Cardiology, Ankang City Central Hospital, Ankang 725000, Shaanxi, China)
关键词:
中心静脉置管; 并发症; 导管堵塞
Keywords:
central venous catheterization;  complication;  catheter occlusion
分类号:
R472
DOI:
-
文献标识码:
A
摘要:
目的:比较三种中心静脉导置管路径的优劣。方法:回顾性分析314例行中心静脉置管的住院患者资料，根据置管路径不同分为3组，颈内静脉路径组103例，锁骨下静脉路径组105例，股静脉路径组106例，比较其穿刺成功率、置管成功率、置管时间及各种并发症的发生率。结果:3组中无1例发生空气栓塞、深静脉血栓形成及心律失常。3组内穿刺成功率、置管成功率、置管时间及局部渗血、血肿、血气胸、中心静脉导管相关性血流感染、导管堵塞及导管脱出的发生率比较，差别无统计学意义。结论:三种路径的使用效果和安全性无显著差异。
Abstract:
AIM:To explore the advantages and disadvantage of three different accesses for central venous catheterization. METHODS: Clinical data of 314 patients who underwent central venous catheterization were retrospectively analyzed. According to different catheterization accesses, 314 cases were divided into three groups: internal jugular vein group (n=103), subclavian vein group (n=105) and femoral vein group (n=106). Success rate of puncture, success rate of central venous catheterization, mean time of catheterization and incidence of different complications were compared among the three groups. RESULTS: Air embolism, deep venous thrombosis or arrhythmia occurred in none of the three groups. Differences among the three groups were not significant in success rate of puncture, success rate of central venous catheterization, mean time of catheterization, incidence of local bleeding, hematoma, hemopneumothorax, central catheterrelated bloodstream infection, catheter occlusion and catheter dislocation. CONCLUSION: The safety and effectiveness of three venous accesses for central venous catheterization showed no significant differences.

参考文献/References

[1]Stocco JG,Crozeta K,Taminato M,et al.Evaluation of the mortality of neonates and children related to the use of central venous catheters: a systematic review[J].Acta Paulista de Enfermagem,2012,25(1):90-95.

[2]Ge X,Cavallazzi R,Li C,et al.Central venous access sites for the prevention of venous thrombosis, stenosis and infection[J].Cochrane Database Syst Rev,2012, 3:CD004084.

[3]Lipshutz AK,Gropper MA.Central venous catheters: Follow the evidence, not the guidelines*[J].Critical Care Medicine,2012,40(8):2528-2529.

[4]Lee OK,Johnston L.A systematic review for effective management of central venous catheters and catheter sites in acute care paediatric patients[J].Worldviews on EvidenceBased Nursing,2005,2(1):4-13.

[5] Dariushnia SR,Wallace MJ,Siddiqi NH,et al.Quality improvement guidelines for central venous access[J].J Vasc Interv Radiol,2010,21(7):976-981.

[6]O'Grady NP,Alexander M,Burns LA,et al.Guideline for the prevention of intravascular catheterrelated infections,2011[J].Clinic Infect Dis,2011,52(9):e162-e193.

[7]Pittiruti M,Hamilton H,Biffi R,et al.ESPEN Guidelines on Parenteral Nutriton Central Venous Catheters access,care,diagnosis and therapy of complications[J]. Clinical Nutrition,2009,28(4):365-377.

[8]Pikwer A,Baath L,Davidson B,et al.The incidence and risk of central venous catheter malpositioning: a prospective cohort study in 1619 patients[J]. Anaesth Intensive Care,2008,36(1):30-37.

[9]Matsumoto CG,Drew BJ,Ide B. Why Should Nurses Closely Monitor the ECG During Insertion or Exchange of a Central Venous Catheter?[J].Prog Cardiovasc Nurs,2012,15(1):29-30.

[10]Agrawal S,Payal YS,Sharma JP.A retrospective clinical audit of 696 central venous catheterizations at a tertiary care teaching hospital in India[J].J Emerg Trauma Shock,2012,5(4):304-308.

[11]Deshpande KS,Hatem C,Ulrich HL,et al.The incidence of infectious complications of central venous catheters at the subclavian, internal jugular, and femoral sites in an intensive care unit population*[J].Critical care medicine,2005,33(1):13-20.

[12]Alexandrou E,Murgo M,Calabria E,et al.Nurseled central venous catheter insertionprocedural characteristics and outcomes of three intensive care based catheter placement services[J].Int J Nurs Stud,2012,49(2):162-168.

[13]周 宏,姜亦虹,沈 黎,等.综合医院ICU中心静脉导管相关性血流感染发生率及危险因素[J].中华医院感染学杂志,2012,22(12):2512-2514.

[14]Rupp ME,Cassling K,Faber H,et al.Hospitalwide assessment of compliance with central venous catheter dressing recommendations[J].Am J Infect Control,2013,41(1):89-91.

[15]赵丽萍,王文丽,夏春芳,等.中心静脉导管相关性纤维蛋白鞘预防和治疗进展[J].中国现代医学杂志,2012,22(18):62-65.

[16]胡彩珍.ICU病人中心静脉导管堵塞的原因分析与护理[J].全科护理,2011,9(2):480-481.

备注/Memo

备注/Memo:
收稿日期：2012-12-06.作者简介：祝鹏，主治医师 Email：dr.zhupeng@tom.com
更新日期/Last Update: 2013-07-29