[1]陈雅玫,石新华,张煜*.藻酸盐敷料在经外周静脉置入中心静脉导管后穿刺点止血中的对比研究[J].中国微创外科杂志,2017,17(07):606-608.
　Chen Yamei,Shi Xinhua,Zhang Yu..A Comparative Study on Hemostasis Effect of Alginate Dressing for Puncture Point Bleeding After Peripheral Insertion of Central Venous Catheter[J].Chinese Journal of Minimally Invasive Surgery,2017,17(07):606-608.
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藻酸盐敷料在经外周静脉置入中心静脉导管后穿刺点止血中的对比研究()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
17
期数:
2017年07期
页码:
606-608
栏目:
临床论著
出版日期:
2017-07-20

文章信息/Info

Title:
A Comparative Study on Hemostasis Effect of Alginate Dressing for Puncture Point Bleeding After Peripheral Insertion of Central Venous Catheter
作者:
陈雅玫; 石新华; 张煜*
北京大学第三医院肿瘤化疗与放射病科，北京100083
Author(s):
Chen Yamei;  Shi Xinhua;  Zhang Yu.
Department of Oncology and Radiation Sickness, Peking University Third Hospital, Beijing 100083, China
关键词:
经外周静脉穿刺中心静脉置管;  包扎方式; 藻酸盐敷料
Keywords:
Peripherally inserted central catheter; Bandage method; Alginate dressing
文献标志码:
A
摘要:
目的探讨藻酸盐敷料对于经外周静脉穿刺中心静脉置管(peripherally inserted central catheters，PICC)术后穿刺点的止血效果。方法选取2013年11月~2016年5月在我科超声引导下改良塞丁格技术（modified Seldinger technique，MST）行PICC置管的538例肿瘤患者，其中2013年11月~2015年2月270例为对照组，PICC置管成功后，穿刺点应用无菌纱布+3M透明贴膜固定；2015年3月~2016年5月268例为观察组，置管成功后穿刺点应用藻酸盐敷料+无菌纱布+3M透明贴膜固定。2组置管成功后均按压穿刺点20 min，弹力绷带加压固定24 h。比较2组24 h内、24~72 h穿刺点出血程度(浸血面积<1 cm×1 cm为轻度，1 cm×1 cm及3 cm×3 cm之间为中度，≥3 cm×3 cm为重度)和换药次数。结果观察组穿刺点轻度、中度、重度出血24 h内为分别为232例、34例、2例，24~72 h为242例、25例、1例，对照组为12例、196例、62例和21例、212例、37例，差异有显著性（Z=-18.647、-18.768，P=0.000、0.000）。观察组穿刺点换药0次、1次、2次、≥3次24 h内为分别为232例、33例、3例、0例，24~72 h为242例、25例、1例、0例，对照组为12例、196例、51例、11例和21例、209例、37例、3例，差异有显著性（Z=-18.560、-18.755，P=0.000、0.000）。结论藻酸盐敷料对于超声引导下MST技术行PICC术后穿刺点止血效果满意。
Abstract:
ObjectiveTo investigate the hemostasis effect of alginate dressing for puncture point bleeding after peripherally inserted central catheter (PICC) by ultrasound-guided modified Seldinger technique (MST).MethodsBetween November 2013 and May 2016, 538 cases of cancer in our department underwent PICC, including 270 cases from November 2013 to February 2015 selected as control group (after PICC was successfully placed, sterile gauze and 3M transparent film were used to fix the puncture point) and 268 cases from March 2015 to May 2016 selected as observation group (after PICC was successfully placed, alginate dressing, sterile gauze and 3M transparent film were used to fix the puncture point). The patients in both groups were given 20 minutes of pressure for puncture point and elastic bandage compression fixation for 24 h. The degree of puncture point bleeding and times of dressing change in 24 h and 24-72 h between the two groups were compared. ResultsIn the observation group, mild, moderate, and severe bleeding was seen in 232 cases, 34 cases, and 2 cases within 24 h, and in 242 cases, 25 cases, and 1 case between 24-72 h, respectively. In the control group, mild, moderate, and severe bleeding was seen in 12 cases, 196 cases, and 62 cases within 24 h, and in 21 cases, 212 cases, and 37 cases between 24-72 h, respectively, with significant differences (Z=-18647, P=0000; Z=-18.768, P=0.000). In the observation group, there were zero, once, twice, and ≥3 times of puncture point dressing change in 232 cases, 33 cases, 3 cases, and 0 case within 24 h and in 242 cases, 25 cases, 1 case, and 0 case between 24-72 h, respectively. In the control group, there were zero, once, twice, and ≥3 times of puncture point dressing change in 12 cases, 196 cases, 51 cases, and 11 cases within 24 h and in 21 cases, 209 cases, 37 cases, and 3 cases between 24-72 h, respectively, with significant differences (Z=-18.560, P=0.000; Z=-18.755, P=0.000).ConclusionThe hemostasis effect of alginate dressing for puncture point bleeding after ultrasound-guided PICC by MST is satisfactory.

参考文献/References:

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备注/Memo

备注/Memo:
*通讯作者，E-mail：dentdoctor@sohu.com
更新日期/Last Update: 2017-09-21