[外周静脉穿刺中心静脉置管在炎症性肠病患者全胃肠外营养中的应用价值]
[Usefulness of a peripherally inserted central catheter for total parenteral nutrition in patients with inflammatory bowel disease].
作者信息
Chiba Hirofumi, Endo Katsuya, Izumiyama Yasuhiro, Nakano Takeru, Okamoto Daisuke, Ichikawa Ryo, Nagai Hiroshi, Matsumoto Shin, Yokoyama Naonobu, Yamamoto Katsutoshi, Shimoyama Yusuke, Naito Takeo, Onodera Motoyuki, Kusaka Jun, Hiramoto Keiichiro, Kuroha Masatake, Kanazawa Yoshitake, Kimura Tomoya, Kakuta Yoichi, Kinouchi Yoshitaka, Shimosegawa Tooru
机构信息
Division of Gastroenterology, Tohoku University Graduate School of Medicine.
Division of Gastroenterology, Tohoku Medical and Pharmaceutical University.
出版信息
Nihon Shokakibyo Gakkai Zasshi. 2017;114(9):1639-1648. doi: 10.11405/nisshoshi.114.1639.
BACKGROUNDS AND AIMS
Peripherally inserted central catheters (PICC) have been widely used as a blood access route for total parenteral nutrition (TPN) in recent years. However, there have been few reports that evaluated the usefulness of PICC for patients with inflammatory bowel disease (IBD). In this study, we compared the clinical courses in patients with IBD who received TPN during their hospitalization by conventional central venous catheters (CVC) and PICC.
PATIENTS AND METHODS
A total of 137 IBD patients were enrolled. The CVC group and the PICC group included 56 and 81 patients, respectively. The clinical courses in both groups were compared retrospectively.
RESULTS
As a complication of the puncture, pneumothorax occurred in two patients (3.6%) in the CVC group, but in none (0%) in the PICC group. The PICC group had significantly higher rates of achieving the scheduled TPN without removing the catheter, lower rates of catheter-related blood stream infection (CRBSI) and longer periods without CRBSI than the CVC group.
CONCLUSION
PICC might be more useful than CVC in terms of safety and the ability to deliver scheduled TPN for IBD patients.
背景与目的
近年来，经外周静脉穿刺中心静脉置管（PICC）已被广泛用作全胃肠外营养（TPN）的血液通路。然而，很少有报告评估PICC对炎症性肠病（IBD）患者的有效性。在本研究中，我们比较了在住院期间接受TPN的IBD患者中，通过传统中心静脉导管（CVC）和PICC的临床病程。
患者与方法
共纳入137例IBD患者。CVC组和PICC组分别包括56例和81例患者。对两组的临床病程进行回顾性比较。
结果
作为穿刺的并发症，CVC组有2例患者（3.6%）发生气胸，而PICC组无一例（0%）发生。与CVC组相比，PICC组在不拔管的情况下完成预定TPN的比率显著更高，导管相关血流感染（CRBSI）的发生率更低，无CRBSI的持续时间更长。
结论
就安全性和为IBD患者提供预定TPN的能力而言，PICC可能比CVC更有用。
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