与导管相关并发症的差异与抗菌药物治疗中长外围静脉导管插入部位的选择:一项随机对照试验
Linfang Zhao1, Xianghong Jin1, Xiangyun Li1
1Nursing Department, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
BMC nursing
|February 5, 2025
概括
选择长外围静脉导管 (长PIVC) 的上臂可显著减少并发症,并延长导管停留时间. 这种插入部位在抗菌疗法期间改善了患者的治疗结果.
科学领域:
- 血管接入装置 血管接入装置
- 传染病管理 传染病管理
- 临床试验 临床试验
背景情况:
- 长外围静脉注射导管 (长PIVC) 对于抗菌疗法至关重要,但最佳插入部位的选择仍在争论中.
- 目前的证据缺乏关于插入部位如何影响长期PIVC相关并发症的共识.
研究的目的:
- 评估上臂插入与前臂插入对长期PIVCs相关并发症的影响.
- 为了比较与导管相关的并发症,插入成功率,手术时间和两个插入部位之间的停留时间.
主要方法:
- 进行了一项涉及90名参与者的随机对照试验.
- 参与者被随机分为两组:前臂 (对照) 或上臂 (实验) 插入长PIVCs.
- 主要结局是导管相关的并发症;次要结局包括插入成功,手术时间和停留时间.
主要成果:
- 实验组 (上臂) 的并发症率明显较低 (25.0%) 与对照组 (66.7%) 相比 (P < 0.001).
- 在上臂组 (中位数为187小时) 与前臂组 (中位数为122小时) 的住院导管持续时间明显更长 (P < 0.001).
- 第一次尝试插入成功率 (97.7% vs 97.4%) 和总程序时间在各组之间是可比的.
结论:
- 长时间PIVC的上臂插入显著减少了导管相关的并发症,特别是血栓炎.
- 这种位置选择也延长了内置导管的持续时间,提高了抗菌药物治疗的有效性.
- 这些发现支持上臂作为长PIVC的首选插入点.
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