University Hospital Maastricht, Department of Internal Medicine, Subdivision of Haematology, P Debyelaan 25, 6229 HX Maastricht, Netherlands.
Eur J Oncol Nurs. 2010 Jul;14(3):200-4. doi: 10.1016/j.ejon.2009.12.005. Epub 2010 Feb 1.
Central venous catheters (CVCs) are frequently used in patients with a haematological malignancy in order to administer chemotherapy, stem cell infusions, blood products, medication, parenteral hyperalimentation as well as for blood sampling. Reported complications consist of mechanical complications during the insertion and long-term complications such as CVC-related thrombosis and infections. CVC-related thrombosis and infections are frequently occurring complications and may cause significant morbidity in patients with haematological malignancies. CVC-related infections and thrombosis should not be considered as a result of modern care or fait accompli and must be one of the priority targets of a multidisciplinary approach emphasizing quality-of-care improvement.
We conducted a survey among 23 Dutch and Belgian haematological centres to assess the local views and clinical practices concerning central venous catheters in haematological patients.
The local protocols and policies differ greatly among the centres probably reflecting wide differentiations in practice across Europe. It also shows lack of evidence concerning CVC-related thrombosis and infections which may cause morbidity in haematological patients. Further research has to be stimulated and development of clinical practice guidelines should be promoted.
在患有血液恶性肿瘤的患者中,经常使用中心静脉导管(CVC)来给予化疗、干细胞输注、血液制品、药物、肠外营养以及进行血液采样。报道的并发症包括插入过程中的机械性并发症和长期并发症,如 CVC 相关血栓形成和感染。CVC 相关血栓形成和感染是经常发生的并发症,可能会导致血液恶性肿瘤患者出现严重的发病率。CVC 相关感染和血栓形成不应被视为现代护理或既成事实的结果,而必须成为强调改善护理质量的多学科方法的优先目标之一。
我们对 23 家荷兰和比利时血液学中心进行了一项调查,以评估当地对血液学患者中心静脉导管的看法和临床实践。
各中心的本地方案和政策差异很大,可能反映了欧洲各地实践的广泛差异。这也表明,CVC 相关血栓形成和感染的证据不足,这可能会导致血液学患者的发病率。需要进一步研究并促进临床实践指南的制定。