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一项关于维持儿童外周静脉留置针的随机对照试验。

A randomized controlled trial for maintaining peripheral intravenous lock in children.

作者信息

Mok Esther, Kwong Tany K Y, Chan Moon Fai

机构信息

School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.

出版信息

Int J Nurs Pract. 2007 Feb;13(1):33-45. doi: 10.1111/j.1440-172X.2006.00607.x.

Abstract

The most effective and safe method of maintaining peripheral intravenous lock in children is an important clinical question that has been identified by the researchers. The results of recent studies comparing saline versus 10 units/ml of heparin saline flush using a 24-gauge catheter in neonatal and pediatric populations are conflicting and inconclusive. The objectives of this study were to evaluate the effectiveness and safety of three flush solutions: normal saline, 1 unit/ml of heparin saline and 10 units/ml of heparin saline for maintaining peripheral intravenous locks in children, and to establish a research-based practice in the study hospital. In a prospective, randomized controlled, double-blind trial, one hundred and twenty-three subjects ranging in age from 1-10 years with 123 intravenous locks were randomly chosen to receive 1 unit/ml of heparin saline, 10 units/ml of heparin saline and normal saline to evaluate length of catheter use, survival rate and incidence of intravenous complications. The study found no statistically significant differences in length of catheter use, estimated catheter survival and the incidence of intravenous complications among the three groups. The group that received 1 unit/ml of heparin saline demonstrated the highest rate of survival. The mean length of catheter use of the group that received 1 unit/ml of heparin saline (49.8 hours) was 17 hours longer than the group that received normal saline (32.5 hours). There are no significant differences among the three types of flushing solution in terms of the catheter longevity and incidence of intravenous complications.

摘要

维持儿童外周静脉留置针的最有效且安全的方法是研究人员已明确的一个重要临床问题。近期针对新生儿和儿童群体,比较使用24号导管时生理盐水与10单位/毫升肝素盐水封管效果的研究结果相互矛盾且尚无定论。本研究的目的是评估三种封管溶液(生理盐水、1单位/毫升肝素盐水和10单位/毫升肝素盐水)在维持儿童外周静脉留置针方面的有效性和安全性,并在研究医院建立基于研究的实践方法。在一项前瞻性、随机对照、双盲试验中,随机选取123名年龄在1至10岁、带有123个静脉留置针的受试者,分别接受1单位/毫升肝素盐水、10单位/毫升肝素盐水和生理盐水,以评估导管使用时长、存活率及静脉并发症发生率。研究发现,三组在导管使用时长、估计的导管存活率及静脉并发症发生率方面无统计学显著差异。接受1单位/毫升肝素盐水的组显示出最高的存活率。接受1单位/毫升肝素盐水的组的平均导管使用时长(49.8小时)比接受生理盐水的组(32.5小时)长17小时。在导管使用寿命和静脉并发症发生率方面,三种封管溶液类型之间无显著差异。

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