Mayo D J, Horne M K, Summers B L, Pearson D C, Helsabeck C B
Warren Grant Magnuson Clinical Center of the National Institutes of Health in Bethesda, MD, USA.
Oncol Nurs Forum. 1996 Oct;23(9):1401-5.
PURPOSE/OBJECTIVES: To determine whether the addition or a heparinized saline flush would decrease clot formation and persistent withdrawal occlusion (PWO) in Groshong (Bard Access Systems, Salt Lake City, UT) catheters.
A prospective, nonrandomized study using a historical control group of patients with Groshong catheters that had been flushed weekly with 5 ml normal saline compared to data from patients with Groshong catheters flushed weekly with 2.5 ml heparinized saline (100 U/ml). A retrospective chart review was performed to determine the incidence of PWO. In both groups, the presence of liquid blood and adherent or nonadherent clot in explanted catheters was recorded.
Oncology inpatient and outpatient units of a cancer research center located in a mid-Atlantic city in the United States.
Twenty-eight 9.5 Fr. double-lumen Groshong catheters maintained with a saline flush. Experimental group: Twenty-three double-lumen Groshong catheters maintained with a heparin flush. At the time of this report, 12 of these 23 catheters had been explanted and 11 remained in place.
The frequency of PWO was measured in a retrospective chart review and determined by the number of urokinase instillations required for each catheter. All 28 catheters in the saline flush group and 8 catheters in the heparin flush group were examined immediately after removal for intraluminal liquid blood and adherent or nonadherent clot.
Urokinase usage, intra-luminal blood or clot, and PWO.
PWO occurred less frequently in the heparin flush group (p = 0.006) than in the saline fush group. All 28 of the saline flush catheters developed an adherent clot in one or both lumens, whereas no adherent clots were found in the heparin flush catheters (p < 0.0001).
The addition of a heparinized saline weekly flush to maintain Groshong catheters decreased the presence of intraluminal adherent clots and improved the catheter function.
The safe delivery of medication and the ability to obtain blood specimens are vital for patients who depend on functioning venous access catheters. Flushing Groshong catheters with heparinized saline decreases the likelihood of intraluminal clot formation and catheter malfunction.
目的/目标：确定添加肝素盐水冲洗液是否会减少Groshong（巴德接入系统公司，美国犹他州盐湖城）导管中的血栓形成和持续性拔管阻塞（PWO）。
一项前瞻性、非随机研究，将一组使用5毫升生理盐水每周冲洗一次的Groshong导管患者作为历史对照组，与一组使用2.5毫升肝素盐水（100单位/毫升）每周冲洗一次的Groshong导管患者的数据进行比较。通过回顾性病历审查来确定PWO的发生率。在两组中，记录取出的导管中液态血液以及附着或未附着血栓的情况。
位于美国大西洋中部一座城市的癌症研究中心的肿瘤住院部和门诊部。
28根9.5 Fr双腔Groshong导管，用生理盐水冲洗进行维护。实验组：23根双腔Groshong导管，用肝素冲洗进行维护。在撰写本报告时，这23根导管中有12根已被取出，11根仍在位。
通过回顾性病历审查测量PWO的发生频率，并根据每根导管所需的尿激酶注入次数来确定。盐水冲洗组的所有28根导管以及肝素冲洗组的8根导管在拔除后立即进行检查，查看管腔内液态血液以及附着或未附着的血栓情况。
尿激酶使用情况、管腔内血液或血栓以及PWO。
肝素冲洗组的PWO发生率低于盐水冲洗组（p = 0.006）。盐水冲洗组的所有28根导管在一个或两个管腔中都形成了附着性血栓，而肝素冲洗组的导管中未发现附着性血栓（p < 0.0001）。
每周添加肝素盐水冲洗以维护Groshong导管可减少管腔内附着性血栓的形成并改善导管功能。
对于依赖静脉通路导管发挥功能的患者，安全给药和获取血标本的能力至关重要。用肝素盐水冲洗Groshong导管可降低管腔内血栓形成和导管故障的可能性。
