目的:不同指南对PICC封管液选择的(生理盐水或肝素钠)意见不一,需进一步验证其临床效果.本研究旨在比较单纯生理盐水与单纯0.16%肝素钠封管液在肿瘤患者住院化学治疗(以下简称"化疗")期间经外周静脉穿刺后置入中心静脉导管(peripherally inserted central catheter,PICC)封管中的临床效果.方法:选择2020年6月至2021年6月在北京协和医院肿瘤内科PICC置管化疗的180例肿瘤患者为研究对象,并根据纳入时间顺序分为生理盐水组(先纳入的90例患者)和肝素钠组(后纳入的90例患者).2组患者住院期间分别采用生理盐水和0.16%肝素钠进行PICC封管,出院当天均采用0.16%肝素钠封管.比较2组患者年龄、性别、体重指数(body mass index,BMI)、凝血功能、置管时间等资料;根据堵管次数、封管费用等指标对两种封管方式进行评价.结果:2组年龄、性别、凝血功能、BMI等资料比较,差异均无统计学意义(均P>0.05);肝素钠组住院封管液配制时间、住院时间、住院封管费用均高于生理盐水组,差异均有统计学意义(均P<0.001).结论:选择肿瘤患者在院化疗期间PICC封管液时,生理盐水与0.16%肝素钠的封管效果无明显差异,但若考虑患者需要连续化疗的情况,以及综合经济因素与护士工作效率的影响,使用生理盐水封管较使用0.16%肝素钠封管更为经济、方便.
Comparison of normal saline and 0.16%heparin sodium for PICC flushing in cancer patients undergoing chemotherapy
Objective:There is no consensus in various guidelines regarding the choice of flushing solution(normal saline or heparin sodium)for peripherally inserted central catheter(PICC)maintenance,necessitating further clinical verification.This study aims to compare the clinical effectiveness of normal saline versus 0.16%heparin sodium as flushing solutions for PICC maintenance in cancer patients during inpatient chemotherapy.Methods:A total of 180 cancer patients who underwent PICC placement for chemotherapy in the Cancer Center of Peking Union Hospital from June 2020 to June 2021 were enrolled and divided into 2 groups based on the order of inclusion:The saline group(first 90 patients)and the heparin sodium group(subsequent 90 patients).During hospitalization,the saline group used normal saline for flushing,while the heparin sodium group used 0.16%heparin sodium.Upon discharge,both groups used 0.16%heparin sodium for flushing.Demographic data such as age,sex,body mass index(BMI),coagulation function,and catheterization duration were compared between groups.The flushing methods were evaluated based on the number of catheter occlusions and flushing costs.Results:No significant differences were found between the 2 groups in terms of age,sex,coagulation function,or BMI(all P>0.05).The heparin sodium group had significantly longer preparation time for flushing solution,hospital stay,and higher flushing costs during hospitalization compared to the saline group(all P<0.001).Conclusion:During inpatient chemotherapy,the flushing effectiveness of normal saline is comparable to that of 0.16%heparin sodium for PICC maintenance.Considering the need for continuous chemotherapy,economic factors,and nursing efficiency,normal saline is a more cost-effective and convenient option for PICC flushing compared to 0.16%heparin sodium.
peripherally inserted central catheterheparin sodiumnormal saline solutioncancerflushing