门诊患者PICC安全性的分析和比较

doi:10.3969/j.issn.1009-976X.2022.03.010

摘要/Abstract

摘要： 目的探讨PICC置管在门诊患者中使用和维护的安全性。方法收集2015年11月至2020年7月广州第一人民医院肿瘤科住院及出院患者实施PICC置管的随访资料,分析和比较门诊和住院两个阶段PICC管的使用并发症发生情况。结果共537例患者纳入研究范围并进行612次PICC置管,总留置时间为18292天,其中住院期间带管时间为7954天（43.5%）,门诊带管时间为10338天（56.5%）。共记录了98例次PICC相关并发症,门诊共45例次（7.2%）,入院患者则有54例次（7.3%）,大多为接受化疗或化疗联合治疗,占总并发症的74.5%。总并发症发生率为5.02/1000导管天,其中门诊组的并发症发生率为4.69/1000导管天,住院组为5.21/1000导管天,两者间差异没有统计学意义（OR=0.881;95%CI： 0.773 ~ 1.892, P=0.639）。最常见的并发症是插管部位的局部炎症（6.2%）、静脉血栓形成（2.8%）、血液感染（2.1%）和PICC管闭塞（1.5%）。结论门诊患者中使用和维护PICC管是安全的,不会导致其并发症风险加大。

关键词: PICC, 并发症, 出院患者

Abstract: Objective To investigate the safety of PICC catheterization for outpatients. Methods The follow-up data of PICC catheterization for inpatients and discharged patients were analyzed in Department of Oncology of Guangzhou first people's Hospital from november 2015 to July 2020, including the complications of PICC catheterization during outpatient and inpatient periods, and compare the complication rate of PICC tube in two different stages of outpatient and inpatient period. Results 537 patients were included in the study and underwent 612 PICC catheterization. The retention time was 18 292 days, including 7954 days （43.5%） during hospitalization and 10338 days （56.5%） during outpatient care. A total of 98 PICC related complications were recorded, including 45 outpatient cases （7.2%） and 54 inpatients （7.3%）, and most of complications resulted from chemotherapy or combined chemotherapy, accounting for 74.5%. The complication rate was 5.02/1000 catheter days, including 4.69/1000 catheter days in the outpatient group and 5.21/1000 catheter days in the inpatient group. There was no significant difference between the two groups （OR=0.981; 95%CI： 0.773~1.892, P=0.939）. The most common complications were local inflammation at the intubation site （6.2%）, venous thrombosis （2.8%）, blood infection （2.1%）, and PICC tube occlusion （1.5%）. Conclusion It is safe when using and maintaining PICC tubes in outpatients without increasing the risk of complications.

Key words: peripherally inserted central venous catheter （PICC）, complications, outpatients

中图分类号:

R608

吴贝贝, 杨凤. 门诊患者PICC安全性的分析和比较[J]. 岭南现代临床外科, 2022, 22(03): 267-271.

WU Bei-bei, YANG Feng. Safety analysis and comparison of peripherally inserted central venous catheter in outpatients and inpatients[J]. Lingnan Modern Clinics In Surgery, 2022, 22(03): 267-271.

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