Department of Hepatobiliary and Pancreas Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China.
School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China.
J Vasc Access. 2022 May;23(3):436-442. doi: 10.1177/1129729821998528. Epub 2021 Mar 12.
The primary purpose of this study was to explore the safety of peripheral intravenous catheter (PIVC) replacement every 96 h compared to that of clinically indicated catheter removal.
A prospective, single-blind, randomized controlled trial was conducted. A random number table method was used. Six hundred patients treated with PIVC intravenous infusion in 10 nursing units of a hospital from September to October 2019 were selected. Sixty were collected from each nursing unit, including 30 in the clinically indicated replacement group and 30 in the routine replacement group. The incidence of phlebitis, catheter-related infection (CRI), occlusion, infiltration, and any form of infusion therapy failure were compared between the two groups. SPSS 23.0 software was used.
The dwelling times of PIVC in the clinically indicated replacement group and routine replacement group were significantly different (hours) (83.62 ± 50.08, 69.75 ± 25.54, = 3.021, = 0.003). The incidence of any form of infusion therapy failure (RR = 4.448, 95% CI: 3.158-6.265, < 0.001), phlebitis (RR = 2.416, 95% CI: 1.595-3.660, < 0.001), occlusion (RR = 6.610, 95% CI: 3.062-14.268, < 0.001), infiltration (RR = 2.607, 95% CI: 1.130-6.016, = 0.020), accidental dislodgement (RR = 2.027, 95% CI: 1.868-2.200, = 0.013), and pain at the insertion site (RR = 2.521, 95% CI: 1.742-3.649, < 0.001) was higher in the clinically indicated replacement group than that in the routine replacement group. The overall survival curve of PIVC was drawn with Kaplan-Meier survival analysis. The median survival time of intravenous infusion was 59.58 h; the cumulative survival rates of 48 h, 72 h, and 96 h were 77.00%, 51.33%, and 20.33%, respectively.
Replacement of PIVC every 96 h is safer than clinically indicated.
本研究的主要目的是探讨外周静脉导管（PIVC）每 96 小时更换与临床指示导管拔出相比的安全性。
采用前瞻性、单盲、随机对照试验。使用随机数字表法。2019 年 9 月至 10 月，从医院的 10 个护理单元中选择了 600 名接受 PIVC 静脉输液治疗的患者。每个护理单元各采集 60 例，包括临床指示更换组 30 例和常规更换组 30 例。比较两组患者静脉炎、导管相关性感染（CRI）、堵塞、渗出和任何形式的输液治疗失败的发生率。采用 SPSS 23.0 软件进行分析。
临床指示更换组和常规更换组的 PIVC 留置时间（小时）分别为（83.62±50.08）和（69.75±25.54），差异有统计学意义（=3.021，=0.003）。任何形式的输液治疗失败（RR=4.448，95%CI：3.158-6.265，<0.001）、静脉炎（RR=2.416，95%CI：1.595-3.660，<0.001）、堵塞（RR=6.610，95%CI：3.062-14.268，<0.001）、渗出（RR=2.607，95%CI：1.130-6.016，=0.020）、意外脱出（RR=2.027，95%CI：1.868-2.200，=0.013）和置管部位疼痛（RR=2.521，95%CI：1.742-3.649，<0.001）的发生率均高于临床指示更换组。采用 Kaplan-Meier 生存分析绘制 PIVC 的总体生存曲线。静脉输液的中位生存时间为 59.58 小时；48 小时、72 小时和 96 小时的累积生存率分别为 77.00%、51.33%和 20.33%。
每 96 小时更换 PIVC 比临床指示更安全。
