外周性静脈内栄養中の血栓炎の発生にカテーテルタイプの影響
M Madan1, D J Alexander, M J McMahon
1Department of Surgery, General Infirmary, Leeds.
Lancet (London, England)
|January 11, 1992
まとめ
外周静脈注入の給餌に細孔シリコンキャセターを使用すると,テフロンカヌラと比較して,血栓炎のリスクが著しく低下します. これにより,外周静脈経由で,より安全で栄養的に適切な親腸栄養を可能にします.
科学分野:
- 医学科学 医学科学 医学科学 医学科学
- クリニカル・ニュートリション
- 血管へのアクセス装置
背景:
- 血栓塞栓炎は,外周静脈注入栄養の一般的な合併症です.
- トロンボフレビティスを緩和するための現在の戦略は,栄養溶液のオスモラリティの変化を伴う.
- 血小板炎の発症における伝達系の役割については,さらなる調査が必要である.
研究 の 目的:
- 細孔シリコンカテーテルと,外周静脈注入栄養のためのテフロンカヌラとの間で,血栓炎の発生率を比較する.
- 配達系が血小板炎の発症に及ぼす影響を評価する.
- 周辺静脈栄養が中央静脈栄養の有効な代替手段であるかどうかを判断する.
主な方法:
- 細い孔のシリコンカテーテルと短いテフロンカヌラをランダムに比較した.
- 標準的な高オスモラリティの栄養素溶液 (1250 mOsmol/kg) を外側から投与した.
- 27人の患者はシリコンキャセター経由で,23人はテフロンカヌラ経由で輸液を受けた.
主要な成果:
- トロンボフレビティスは,シリコンカテーテルを使用した患者の7%で,テフロンカヌラを使用した患者の100%で発生しました.
- カテーテル通路の平均持続時間は,テフロンカヌラ (40時間) よりも,シリコンカテーテル (128.5時間) の方が有意に長かった.
- 高オスモラリティの栄養素溶液の周縁送達のために,超細孔シリコンキャセターを使用すると,血栓炎のリスクは低い.
結論:
- 細孔のシリコンキャセターは,外周静脈注入栄養中の血栓炎を予防する点でテフロンカヌラよりも優れています.
- 高オスモラリティの溶液による周周周静脈注射は,適切な投与システムを用いて実行可能で安全です.
- このアプローチは,外周静脈の利用を親腸栄養に拡大し,患者のケアを改善する可能性がある.
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