肝素封管和生理盐水封管在白血病患儿植入静脉输液港中效果比较(1)
[摘要] 目的 比较肝素封管和生理盐水封管在白血病患儿植入静脉输液港中的效果。 方法 采用方便抽样法抽取2015年12月～2017年3月在首都儿科研究所附属儿童医院血液肿瘤科住院的40例白血病患儿，按照时间顺序通过赛丁格技术在外科经右颈内静脉植入静脉输液港；前20例为实验组，后20例为对照组。实验组先10 mL生理盐水在每日输液结束后进行脉冲封管，再采用5 mL生理盐水正压封管。对照组采用常规方法，先使用10 mL生理盐水脉冲冲管，再使用5 mL肝素盐水(10 U/mL)正压封管。观察两种方法封管后输液港在导管堵塞方面是否存在差异。 结果 在连续输液期间，两组的患儿导管堵塞发生率差异无统计学意义(P ﹥ 0.05)。 结论 在连续输液期间，每日只使用生理盐水为植入静脉输液港的白血病患儿进行封管，不会增加管道堵塞的发生概率，值得推广应用。
[关键词] 输液港；白血病；脉冲式冲管；正压封管
[中图分类号] R473.73 [文献标识码] A [文章编号] 1673-7210(2018)10(a)-0178-04
Comparison of two sealing methods of implanted port in patients with leukemia
WANG Cui CAO Tingting ZHAO Bo
Department of Hematology， Children′s Hospital， Capital Institute of Pediatrics， Beijing 100020， China
[Abstract] Objective To compare the effects of heparin sealing and saline sealing in the implantation of intravenous infusion port in children with leukemia. Methods A total of 40 children with leukemia admitted to the Department of Hematology， Children′s Hospital of Capital Institute of Pediatrics， from December 2015 to March 2017， were selected by sampling technique. All children were surgically passed through the Sytech technique in the right neck. The internal vein was implanted into the intravenous infusion port. The first 20 cases were the experimental group， and the last 20 cases were the control group. The experimental group was sealed with 10 mL of normal saline at the end of the daily infusion， and then sealed with 5 mL of normal saline. The control group was routinely pulsed with 10 mL of normal saline， and then sealed with 5 mL of heparin saline (10 U/mL). Whether there were differences in catheter occlusion after the two methods were observed. Results During continuous infusion， there was no significant difference in the occurrence of catheter occlusion between the two groups (P > 0.05). Conclusion During the continuous infusion， the daily use of saline alone for the closure of children with leukemia in the port of intravenous infusion does not increase the incidence of tube blockage， which is worthy of popularization and application.
[Key words] Implanted port； Leukeamia； Pulse type flushing； Positive pressure locking
植入式輸液港是1982年首次报道应用的一种完全植入人体的闭合静脉系统[1]，可用于输注各种药物、输注血液制品、进行血样采集等[2]。其避免了反复穿刺带来的痛苦和难度，多用于保护肿瘤患者免受化疗药的静脉毒性[3]，有利于防止并发症，避免化疗药外渗，减少感染风险，提高患者的生活质量[3]。输液港植入成功后，港体及导管埋于体内，每月维护1次[4]，减少了穿刺次数及导管接头被污染、院外感染的风险[5]。输液港可以为患者长期提供静脉血管通道，将各种药物直接输送至中心静脉[6]，且患者生活不受限制，生命质量高，患者满意度较高[7]。按照每周更换1次无损伤蝶翼针计算，输液港座可以承受1000次穿刺，可使用19年[1]。然而，导管阻塞是静脉输液港常见的并发症之一[8]，输液港堵塞发生率为1.9%～25.0[9]，影响输液港使用的年限和安全性[10]。因此，输液港植入期间的抗凝、充分冲管及正确选择封管液和封管方法是输液港使用过程中最为重要的环节。, 百拇医药(王翠 曹婷婷 赵博)
[关键词] 输液港；白血病；脉冲式冲管；正压封管
[中图分类号] R473.73 [文献标识码] A [文章编号] 1673-7210(2018)10(a)-0178-04
Comparison of two sealing methods of implanted port in patients with leukemia
WANG Cui CAO Tingting ZHAO Bo
Department of Hematology， Children′s Hospital， Capital Institute of Pediatrics， Beijing 100020， China
[Abstract] Objective To compare the effects of heparin sealing and saline sealing in the implantation of intravenous infusion port in children with leukemia. Methods A total of 40 children with leukemia admitted to the Department of Hematology， Children′s Hospital of Capital Institute of Pediatrics， from December 2015 to March 2017， were selected by sampling technique. All children were surgically passed through the Sytech technique in the right neck. The internal vein was implanted into the intravenous infusion port. The first 20 cases were the experimental group， and the last 20 cases were the control group. The experimental group was sealed with 10 mL of normal saline at the end of the daily infusion， and then sealed with 5 mL of normal saline. The control group was routinely pulsed with 10 mL of normal saline， and then sealed with 5 mL of heparin saline (10 U/mL). Whether there were differences in catheter occlusion after the two methods were observed. Results During continuous infusion， there was no significant difference in the occurrence of catheter occlusion between the two groups (P > 0.05). Conclusion During the continuous infusion， the daily use of saline alone for the closure of children with leukemia in the port of intravenous infusion does not increase the incidence of tube blockage， which is worthy of popularization and application.
[Key words] Implanted port； Leukeamia； Pulse type flushing； Positive pressure locking
植入式輸液港是1982年首次报道应用的一种完全植入人体的闭合静脉系统[1]，可用于输注各种药物、输注血液制品、进行血样采集等[2]。其避免了反复穿刺带来的痛苦和难度，多用于保护肿瘤患者免受化疗药的静脉毒性[3]，有利于防止并发症，避免化疗药外渗，减少感染风险，提高患者的生活质量[3]。输液港植入成功后，港体及导管埋于体内，每月维护1次[4]，减少了穿刺次数及导管接头被污染、院外感染的风险[5]。输液港可以为患者长期提供静脉血管通道，将各种药物直接输送至中心静脉[6]，且患者生活不受限制，生命质量高，患者满意度较高[7]。按照每周更换1次无损伤蝶翼针计算，输液港座可以承受1000次穿刺，可使用19年[1]。然而，导管阻塞是静脉输液港常见的并发症之一[8]，输液港堵塞发生率为1.9%～25.0[9]，影响输液港使用的年限和安全性[10]。因此，输液港植入期间的抗凝、充分冲管及正确选择封管液和封管方法是输液港使用过程中最为重要的环节。, 百拇医药(王翠 曹婷婷 赵博)