ISSN 2096-7446　CN 10-1655/R
主管：中国科协技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2023, Vol. 4 ›› Issue (7): 581-586.doi: 10.3761/j.issn.2096-7446.2023.07.001

• 论著 •    下一篇

不同封管方法在肿瘤患者完全植入式静脉输液港中的应用效果研究

朱薇 钦晓英 黄培培 项小燕 卢琪 陈立姣 崔智萍 张烨   

  • 出版日期:2023-07-10 发布日期:2023-07-07

Study on the application effect of different sealing solutions in the totally implantable venous access portamong tumor patients

ZHU Wei，QIN Xiaoying，HUANG Peipei，XIANG Xiaoyan，LU Qi，CHEN Lijiao，CUI Zhiping，ZHANG Ye   

  • Online:2023-07-10 Published:2023-07-07

摘要：

目的  比较不同封管方法对肿瘤患者完全植入式静脉输液港中的应用效果。 方法 选取2018年12月—2022年12月在浙江省某三级甲等医院门诊植入输液港的肿瘤患者414例，通过随机数字表法分为A、B、C 3组各138例，A组间歇期维护使用5 ml 0.9%氯化钠正压封管，B组间歇期维护采用5 ml肝素溶液（10 U/ml）正压封管，C组间歇期维护采用5 ml肝素溶液（100 U/ml）正压封管。观察3组患者的凝血功能及输液港堵塞情况。 结果 3组凝血酶原时间、活化部分凝血活酶时间比较，差异具有统计学意义（P＜0.05）；D-二聚体定量、血小板计数、输液港堵塞发生率比较，差异无统计学意义（P＞0.05），见表2。3组凝血酶原时间两两比较结果显示，A组与B组差异无统计学意义（t=-33.268，P＞0.05），但A组与C组（t=-172.406，P<0.001）、B组与C组（t=-139.138，P<0.001）差异均具有统计学意义；3组活化部分凝血活酶时间两两比较结果显示，A组与B组差异无统计学意义（t=1.406，P＞0.05），但A组与C组（t=-35.493，P＜0.05）、B组与C组（t=-36.899，P＜0.05）差异均具有统计学意义。3组输液港堵塞发生率比较，差异无统计学意义（2=1.632，P=0.442）。 结论 采用肝素溶液（100 U/ml）与0.9%氯化钠或肝素溶液（10 U/ml）相比，可延长完全植入式静脉输液港肿瘤患者凝血酶原时间和活化部分凝血活酶时间，建议临床护理人员使用0.9%氯化钠或肝素溶液（10 U/ml）进行封管。

关键词: 输液港, 导管插入术, 中心静脉, 肝素, 盐溶液, 危重病护理

Abstract: Objective To compare the application effects of different sealing solutions in totally implantable venous access port among tumor patients. Methods A randomized sampling was used to select 414 patients who were maintained infusion port in outpatient department of a tertiary Grade A hospital in Zhejiang Province from December 2018 to December 2022. They were divided into three groups，A，B，and C，with 138 cases in each group，using a random number table method. Patients were treated with 5 ml 0.9% sodium chloride for positive pressure sealing during intermittent maintenance in group A，and 5 ml heparin（10 U/ml） for positive pressure sealing in group B，and 5ml heparin（100 U/ml） positive pressure sealing in group C. To observe coagulation function and catheter blockage in patients among three groups. Results There were statistically significant differences in prothrombin time and activated partial thrombin time among the three groups（P<0.05）. There was no significant difference in D-dimer quantity and platelet count（P>0.05）. The pair comparison of prothrombin time among the three groups showed that there was no statistical significance between group A and group B（t=-34.409，P>0.05），but there were statistically significant differences between group A and group C（t=-179.308，P<0.001） and between group B and group C（t=-144.899，P<0.001）. The pairwise comparison of activated partial thromboplastin time among the three groups showed that there was no statistical significance between group A and group B（t=1.406，P>0.05）， but there were statistically significant differences between group A and group C（t=-35.493，P<0.05） and between group B and group C（t=-36.899，P<0.05）. Conclusion Among cancer patients with totally implantable access port during intermittent maintenance period，the use of heparin solution（100 U/ml） can prolong prothrombin time andactivated partial thromboplastin time. It is recommended that clinical nursing staff seal the tube with 0.9% sodium chloride or heparin solution（10 U/ml） in outpatient patients undergoing intermittent maintenance.

Key words: Implantable Venous Access Port； Catheterization, Central Venous； Neoplasms； Heparin；Saline Solution； Critical Care Nursing