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find Keyword "中心静脉置管" 6 results
  • Comparison of Two Catheter Implantation Methods in Administering Amphotericin B in Patients with Hematological Malignancies with Fungal Infections

    目的:通过经外周静脉穿刺中心静脉置管(PICC)或锁骨下静脉置管与前臂静脉留置针在血液病患者并发深部真菌感染时应用两性霉素B中的比较,探讨如何减少患者静脉炎及并发症发生率和再次静脉穿刺的发生率,从而提高患者生活质量。方法:80例血液病患者分为两组,40例PICC置管或锁骨下静脉置管组为A组,40例前臂静脉留置针为B组,记录静脉炎、疼痛发生情况、留置时间。结果:A组留置时间30~68天,B组留置时间1~5天;A组静脉炎率5%,B组静脉炎率45%;A组疼痛率5%,B组疼痛率35%;结论:在血液病患者并发深部真菌感染时应用两性霉素B治疗中,选用PICC置管或锁骨下静脉置管效果明显优于前臂静脉留置针,值得临床推广。

    Release date:2016-09-08 10:14 Export PDF Favorites Scan
  • A Study on Catheter Related Infection in Cancer Patient Treated with Central Venous Catheterization

    Objective To study the catheter-related infection (CRI) in cancer patients treated with central venous catheterization. Methods A prospective study with 196 cancer patients was conducted to analyze the types of catheter-related infection and pathogen, as well as the relationship between CRI and the following factors: insert location, gender, age, remained time, or bone marrow suppression. Results Of the total 196 cases, 16 cases were diagnosed as CRI and the CRI rate was 8.2%. The types of CRI were five cases of pathogen colonization, four cases of insert location infection and seven cases of catheter-related bloodstream infection. Of the total 244 specimens, 20 were positive including 7 pathogenic bacteria in either Gram positive or Gram negative types, the dominating pathogens were staphylococcus aureus, staphylococcus epidermidis, acinetobacter baumannii and klebsiella pneumoniae. CRI was related to both insert location and age which were both the independent risk factors. Conclusion The concept of prevention should be set up, and the comprehensive measures should be taken to reduce CRI, such as choosing an appropriate insert location and complying with a strict catheter insert standard.

    Release date:2016-09-07 11:00 Export PDF Favorites Scan
  • The Role of Heparin in Prevention of Neonatal Catheter-related Complications in Peripherally Inserted Central Catheters

    Objective To investigate the role of low-dose heparin added to total nutrient admixture (TNA) solutions in the prevention of catheter related infections (CRIs). Methods One-hundred three newborn infants with periph-erally inserted central catheter (PICC) were divided into heparin group (n=63) and control group (n=40). The patients in the heparin group received TNA with 0.5 U/ ml heparin. The patients in the control group received TNA without heparin. We retrospectively analyzed the incidence of CRTs in the two groups. Results We found that the incidence of CRIs was 0 in the heparin group and 12.5% (5/40) in the control group. The incidence of catheter obstruction was 6.3% (4/63) in the heparin group and 20% (8/40) in the control group. The incidence of catheter-tip colonization was 1.58% (1/40) in the heparin group and 17.5% (7/40) in the control group. The incidences of CRIs, catheter obstruction, and catheter-tip colonization were signiicantly lower in the heparin group than those in the control group (Plt;0.05). Conclusion TNA solutions with 0.5U/ml heparin have decreased catheter obstruction and CRIs.

    Release date:2016-09-07 11:24 Export PDF Favorites Scan
  • Application of B-Mode Ultrasound Locatization in Catheterization of Internal Jugular Vein (Report of 286 Cases)

    目的 讨论B型超声定位下颈内静脉穿刺置管的经验。方法 回顾我中心2008年11月至2009年4月期间采用B型超声定位行颈内静脉置管的286例患者的临床资料。结果 一次性穿刺成功率为99.3%(284/286),置管成功率为100%(286/286); 穿刺时间50 s~12 min,平均106.8 s; 带管时间5~64 d,平均13 d; 未出现血气胸、皮下血肿等并发症。结论 B型超声定位下颈内静脉穿刺操作简单、方便、安全,适用于各级别医院。在颈短肥胖,被动体位情况下,B型超声定位下置管优势大于传统的盲探法及彩色多普勒超声引导下置管法。

    Release date:2016-09-08 10:54 Export PDF Favorites Scan
  • 不同年龄阶段儿童经外周静脉置入中心静脉导管体表测量方法及相关因素探讨

    目的探讨不同年龄阶段儿童经外周静脉置入中心静脉导管(PICC)置管体表测量方法及相关因素。 方法将 2012 年 1 月-2014 年 3 月接受住院治疗的急性淋巴细胞白血病、淋巴瘤、实体瘤、地中海贫血、再生障碍性贫血及组织细胞增生症患儿共 255 例作为研究对象。其中男 137 例(53.7%),女 118 例(46.3%);年龄 6 个月~16岁,平均(6.33±3.76)岁;婴幼儿 48 例(18.8%),学龄前患儿 104 例(40.8%),学龄期及青春期患儿 103 例(40.4%),患儿均在进行化学治疗前安置 PICC 导管。婴幼儿组采取方法 1:术肢与躯干成 90°,自预穿刺点沿静脉走行至右胸锁骨关节的 PICC 置管长度体表测量方法;学龄前期组采取方法 2:术肢与躯干成 90°,自预穿刺点沿静脉走行至右胸锁骨关节再加 1 cm 的 PICC 置管长度体表测量方法;学龄期及青春期组采取方法 3:术肢与躯干成 90°,自预穿刺点沿静脉走行至右胸锁骨关节再加 2 cm 的 PICC 置管长度体表测量方法。比较每组预置长度与最适长度(最适长度 = 实际置入长度+PICC 尖端至上腔静脉下 1/3 段中点的垂直距离)之间的差异;同时分析影响 PICC 置管最适长度的相关因素。 结果婴幼儿组、学龄前期组患儿测得的预置长度与最适长度比较差异无统计学意义(P>0.05);学龄期及青春期组测得的预置长度与最适长度比较差异有统计学意义(P<0.05)。患儿身高、术肢臂围、穿刺侧、穿刺静脉、右侧第 1 胸肋结合处至上腔静脉注入右心房处的垂直距离(距离 1)5 个因素为影响最适长度的相关因素。 结论儿童 PICC 体表测量方法不应完全延用成人的测量方法,可运用方法 1、方法 2 分别对婴幼儿、学龄前期患儿组进行 PICC 置管前体表测量。

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  • Flushing effects of normal saline and heparin saline after central venous catheterization: a meta-analysis

    Objective To evaluate the flushing effects of normal saline (NS) and heparin saline (HPS) after central venous catheterization. Methods We searched PubMed, EMbase, The Cochrane Library (Issue 12, 2015), CBM, CNKI, VIP and WanFang Data to collect randomized controlled trials (RCTs) on the flushing effects of NS versus HPS after central venous catheterization from inception to December 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then RevMan 5.3 software was used for meta-analysis. Results A total of 12 RCTs involving 2 092 patients were included. The results of meta-analysis showed that no significant differences were found between the two groups in occlusion rate (OR=1.58, 95%CI 0.79 to 3.14,P=0.19) and the catheter days (OR=–7.24, 95%CI –22.90 to 8.41,P=0.36), while the HPS group had more advantage than the NS group in decreasing the incidence of phlebitis (OR=2.57, 95%CI 1.52 to 4.34,P=0.000 4). Subgroup analysis revealed that HPS provided more superiority over NS in lessening the occlusion rate (OR=1.85, 95%CI 1.22 to 2.80,P=0.004), no significant difference was found when comparing NS to 10 units, and 100 units HPS (10 units: OR=1.51, 95%CI 0.94 to 2.43,P=0.09; 100 units: OR=1.51, 95%CI 0.63 to 3.60,P=0.09). Conclusion HPS appears to be more beneficial than NS, larger rigorously studies are needed for better understanding on the effects of NS and HPS.

    Release date:2017-01-18 07:50 Export PDF Favorites Scan
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