PICC与JVC在妇科恶性肿瘤术后化疗中应用价值.doc

PICC与JVC在妇科恶性肿瘤术后化疗中应用价值 　　【摘要】 目的 探讨经外周静脉穿刺中心静脉置管(PICC)与颈内静脉置管(JVC)在妇科恶性肿瘤患者静脉化疗中的应用效果。方法 96例置管患者按照住院的先后顺序随机分为PICC组48例和JVC组48例,记录两组一次置管成功率、导管留置时间、并发症的发生等情况并进行分析。结果 PICC组一次置管成功率为95.83%,JVC组的一次置管成功率为79.17%;PICC组导管留置时间7-65天,JVC组导管留置时间12-71天;PICC组的主要并发症为穿刺点渗血,导管滑脱、周围静脉炎。JVC组的主要并发症为皮下血肿、导管相关性感染、导管栓塞。 结论 PICC和JVC各有优缺点:PICC较为安全、护士易于掌握,单人可以操作。长期化疗的病人应首选PICC。选择PICC困难时可以采用JVC,两种方法酌情选用。 　　【关键词】 外周静脉穿刺中心静脉置管 颈内静脉置管 妇科恶性肿瘤 化疗 　　中图分类号:R737.3文献标识号:A 文献编号:1005-0515(2010)09-001-02 　　[Abstract] Objective To investigate the effects in gynecologic cancer patients intravenous chemotherapy by peripherally inserted central catheters (PICC) and internal jugular vein catheter (JVC) . Methods 96 patients with catheter were randomly and equally divided into two according to the order of hospitalization.Two methods recorded once a catheter tube success rate, catheter time, the Incidence of complications and analyzed them. Results PICC group a success rate of catheter 95.83%, JVC group a success rate of 79.17%;PICC Group catheter time 7-65 days, JVC Group catheter time 12-71 days;PICC group of major complications at the puncture site bleeding, Catheter slippage,and vein inflammation. JVC group of major complications subcutaneous hematoma, catheter-related infections, catheter embolization. Conclusions PICC and JVC have their disadvantages: PICC is more security, Nurses are easy to learn, One person can operate. PICC should be preferred for Long-term chemotherapy. JVC is alternative when PICC are difficulties,using the two methods as appropriate. 　　【Key words【 peripherally inserted central catheters (PICC) internal jugular vein catheter (JVC) gynecologic cancer intravenous chemotherapy 　　R737.3A 　　 　　静脉给药化疗是治疗妇科恶性肿瘤的主要方法之一,并且需要经静脉反复多次推注化疗药物,部分病人可能出现全身毒副反应,药物对血管壁的刺激性也很大,长期使用还可引起的外周静脉炎,有时药液漏出血管,轻者可出现局部红、肿、热、痛,重者可引起皮肤及组织损伤坏死,影响下一个疗程的治疗。因此化疗患者的血管选择非常重要。2008年1月―2009年12月,我院在对妇科恶性肿瘤术后患者静脉化疗过程中,分别采取了PICC与JVC化疗,对两种置管方法的临床效果和相关并发症进行比较,有如下体会: 　　1 资料与方法 　　1.1一般资料:我科在2008年1月―2009年12月收治妇科恶性肿瘤术后患者9