乳腺癌患者化疗期间不同静脉输液途径选择与血管保护的关系

文档编号:HL036  文档字数:6051.页数:11

摘要
目的：比较乳腺癌病人患侧上肢和健侧上肢作为PICC输注化疗药物的不同途径引发静脉炎和水肿的发生率。
方法：随机抽取2009年1月至8月间在安徽省肿瘤医院进行乳腺癌手术后化疗患者147例，采用抽签方法将她们随机分为二组。一组为实验组，另一组为对照组。实验组使用乳腺癌患侧上肢作为PICC输注化学治疗药物途径。对照组使用健侧肢体作为PICC导入化学治疗药物途径。比较乳腺癌病人患侧上肢和健侧上肢作为PICC输注化疗药物的不同途径引发静脉炎和水肿的发生率。
结果：经乳腺癌患侧上肢置入PICC导管所造成的静脉炎发生率为16.7%，明显高于健侧组的5.3%（P < 0.05）；患侧组上肢的水肿发生率为26.4%，也显著高于健侧的6.7%（P < 0.01）；同时，患侧组的上肢静脉炎和水肿严重程度都显著高于健侧组（P < 0.05）；较多的患侧组病人不得不提前改用其它化疗途径（P < 0.05）。
结论：为了更好地保护术后乳腺癌患者的血管，应避免使用患侧上肢作为PICC置入的首选途径。

ABSTRACT
OBJECTIVE: This study is to compare rates of phlebitis and swelling caused by peripherally inserted central catheter (PICC) via ipsilateral and contralateral arms in breast cancer patients.
METHODS: A total of 147 breast cancer patients were randomly assigned to two groups: experimental group and control group. The experimental group received chemotherapy via PICC inserted in their ipsilateral arm to their cancer sites. The control group received chemotherapy in contralateral arm. This is to compare rates of phlebitis and swelling induced by the two different ways for PICC infusion of chemotherapy.
RESULTS: The rate of phlebitis induced by ipsilateral PICC is 16.7%, which is significantly higher than 5.3% of contralateral PICC (P < 0.05). The swelling rate of ipsilateral PICC is 26.4%, which is also significantly higher than 6.7% of contralateral PICC (P < 0.01). In comparison with the control group, there were more patients from the experimental group who had to switch to other ways of drug infusion(P < 0,05).
CONCLUSION: To better protect breast cancer patient's blood vessels, the ipsilateral arm should not be used as the first choice for the PICC infusion of chemotherapy.

关键词及定义
乳腺癌：乳腺恶性肿瘤。
外周置入中心静脉置导管（PICC）：经外周静脉穿刺将导管置入中心静脉里（peripherally inserted central catheter）。
化疗：化学药物治疗法。
静脉炎：浅表静脉内膜炎症。
文档类型：类实验性研究。

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