经皮静脉穿刺与外周置入中心静脉导管采集全血细胞计数在血液病患者中的比较：两种方法的比较。
Complete Blood Count Collected Via Venipuncture Versus Peripherally Inserted Central Catheter in Hematological Patients: A Comparison of 2 Methods.
机构信息
Author Affiliations: Department of Oncology, Città della salute e della Scienza di Torino University Hospital (Mss Ponticelli and Volpes); and Department of Public Health and Pediatrics, University of Torino (Drs Clari, Conti and Campagna), Turin; and Department of Oncology, IRCCS Candiolo, Candiolo (TO) (Ms Valenti and Mr Granero), Italy; Department of Cardiology/Vascular, Inselspital, University Hospital of Bern, Bern, Switzerland (Mr Angioni); and Department of Emergency, "E. Agnelli" Pinerolo Hospital, Pinerolo (TO) (Mr Bert), Italy.
出版信息
Cancer Nurs. 2022;45(1):E36-E42. doi: 10.1097/NCC.0000000000000873.
BACKGROUND
The use of peripherally inserted central catheters (PICCs) in cancer care is increasing over traditional central venous catheters. Nurses frequently collect blood by venipuncture when a PICC is inserted, as there is no available evidence to confirm the reliability of blood tests collected through PICCs in adults.
OBJECTIVE
The aim of this study was to assess the reliability of blood samples for complete blood count (CBC) obtained through PICCs as an alternative to venipuncture.
METHODS
A cross-sectional design was used to recruit adult hematological patients. The blood samples were collected within 5 minutes of each other by a specialist nurse. Hemoglobin, hematocrit, and platelet count were evaluated. To determine method comparison, Passing-Bablok regression, test of linearity, Pearson product-moment correlation coefficient, and Bland-Altman plots were used.
RESULTS
Thirty paired blood samples were collected in 29 hematological patients with a mean age of 66.8 years. A statistical difference was found for hemoglobin (P = .001) and hematocrit (P = .001) levels, but no clinical difference. The regression models revealed no systematic differences and no proportional differences with a linear relationship between the methods. Bland-Altman plots highlighted a good agreement between methods.
CONCLUSION
Blood samples for CBC drawn by PICCs are as reliable as those collected via venipuncture. Blood sampling via PICC could be recommended in people with hematological malignancies in needs of frequent blood tests.
IMPLICATIONS FOR PRACTICE
Sampling through a PICC provides reliable laboratory results for CBC, and it could reduce patients' discomfort and increase the safety of professionals reducing the risk of accidental percutaneous needlestick injuries.
背景
在癌症护理中，外周静脉置入中心导管（PICC）的使用正在逐渐超过传统的中心静脉导管。当插入 PICC 时，护士通常会通过静脉穿刺采集血液，因为目前没有证据可以证实成人通过 PICC 采集的血液检验结果的可靠性。
目的
本研究旨在评估通过 PICC 采集的全血细胞计数（CBC）样本的可靠性，以替代静脉穿刺。
方法
采用横断面设计招募成年血液科患者。由一名专科护士在 5 分钟内分别采集这些血液样本。评估血红蛋白、血细胞比容和血小板计数。为了确定方法比较，使用了 Passing-Bablok 回归、线性检验、皮尔逊积矩相关系数和 Bland-Altman 图。
结果
在 29 名平均年龄为 66.8 岁的血液科患者中采集了 30 对血液样本。血红蛋白（P =.001）和血细胞比容（P =.001）水平存在统计学差异，但无临床差异。回归模型显示两种方法之间没有系统差异，也没有比例差异，具有线性关系。Bland-Altman 图突出了两种方法之间的良好一致性。
结论
通过 PICC 采集的 CBC 血液样本与通过静脉穿刺采集的样本一样可靠。在需要频繁进行血液检查的血液恶性肿瘤患者中，可以推荐通过 PICC 进行采血。
实践意义
通过 PICC 采样可提供可靠的 CBC 实验室结果，减少患者的不适，并提高专业人员的安全性，降低意外经皮针刺伤的风险。
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