Brown-Smith J K, Stoner M H, Barley Z A
Penrose Cancer Hospital, Colorado Springs.
Oncol Nurs Forum. 1990 Jul-Aug;17(4):543-9.
Quasi-experimental and descriptive methods were used to investigate thrombosis incidence in 294 tunneled central venous catheters inserted in adult clients with cancer. Thrombosis incidence was measured in relation to heparin flush regimen, internal catheter tip location, and chemotherapy infusate volume. Data were collected for two cohorts: 1) 145 tunneled catheters using 5 ml daily of 10 U/ml heparin flush, and 2) 51 catheters using 10 cc daily of 100 U/ml heparin flush. Data were also collected for an additional 98 catheters (transitional) utilizing a combination of flush #1 and #2 from adjacent time periods. Chi square analysis of the cohorts revealed no difference in thrombosis incidence by flush regimen or chemotherapy infusate volume. Suboptimal internal catheter tip location and catheters placed on the left side were related to higher thrombosis incidence. Practice implications include: the need for staff and patient education regarding signs and symptoms of catheter-related thrombosis, additional systematic data collection and evaluation, and support for empirical research to establish optimal vascular access device care.
采用准实验和描述性方法，对294例成年癌症患者植入的隧道式中心静脉导管的血栓形成发生率进行了调查。根据肝素封管方案、导管内部尖端位置和化疗输注液量来测量血栓形成发生率。收集了两个队列的数据：1）145根隧道式导管，每天使用5毫升10单位/毫升的肝素封管；2）51根导管，每天使用10毫升100单位/毫升的肝素封管。还收集了另外98根导管（过渡性）的数据，这些导管采用了相邻时间段的封管方案1和封管方案2的组合。对这些队列进行卡方分析发现，封管方案或化疗输注液量对血栓形成发生率没有影响。导管内部尖端位置不理想以及放置在左侧的导管与较高的血栓形成发生率相关。实际应用包括：需要对工作人员和患者进行有关导管相关血栓形成的体征和症状的教育，进行额外的系统数据收集和评估，以及支持开展实证研究以确定最佳的血管通路装置护理方法。
