乳腺癌患者化療期間不同靜脈輸液途徑選擇與血管保護的關系

論文編號:HL036  論文字數:6051.頁數:11

摘要
目的：比較乳腺癌病人患側上肢和健側上肢作為PICC輸注化療藥物的不同途徑引發靜脈炎和水腫的發生率。
方法：隨機抽取2009年1月至8月間在安徽省腫瘤醫院進行乳腺癌手術后化療患者147例，采用抽簽方法將她們隨機分為二組。一組為實驗組，另一組為對照組。實驗組使用乳腺癌患側上肢作為PICC輸注化學治療藥物途徑。對照組使用健側肢體作為PICC導入化學治療藥物途徑。比較乳腺癌病人患側上肢和健側上肢作為PICC輸注化療藥物的不同途徑引發靜脈炎和水腫的發生率。
結果：經乳腺癌患側上肢置入PICC導管所造成的靜脈炎發生率為16.7%，明顯高于健側組的5.3%（P < 0.05）；患側組上肢的水腫發生率為26.4%，也顯著高于健側的6.7%（P < 0.01）；同時，患側組的上肢靜脈炎和水腫嚴重程度都顯著高于健側組（P < 0.05）；較多的患側組病人不得不提前改用其它化療途徑（P < 0.05）。
結論：為了更好地保護術后乳腺癌患者的血管，應避免使用患側上肢作為PICC置入的首選途徑。

ABSTRACT
OBJECTIVE: This study is to compare rates of phlebitis and swelling caused by peripherally inserted central catheter (PICC) via ipsilateral and contralateral arms in breast cancer patients.
METHODS: A total of 147 breast cancer patients were randomly assigned to two groups: experimental group and control group. The experimental group received chemotherapy via PICC inserted in their ipsilateral arm to their cancer sites. The control group received chemotherapy in contralateral arm. This is to compare rates of phlebitis and swelling induced by the two different ways for PICC infusion of chemotherapy.
RESULTS: The rate of phlebitis induced by ipsilateral PICC is 16.7%, which is significantly higher than 5.3% of contralateral PICC (P < 0.05). The swelling rate of ipsilateral PICC is 26.4%, which is also significantly higher than 6.7% of contralateral PICC (P < 0.01). In comparison with the control group, there were more patients from the experimental group who had to switch to other ways of drug infusion(P < 0,05).
CONCLUSION: To better protect breast cancer patient's blood vessels, the ipsilateral arm should not be used as the first choice for the PICC infusion of chemotherapy.

關鍵詞及定義
乳腺癌：乳腺惡性腫瘤。
外周置入中心靜脈置導管（PICC）：經外周靜脈穿刺將導管置入中心靜脈里（peripherally inserted central catheter）。
化療：化學藥物治療法。
靜脈炎：淺表靜脈內膜炎癥。
論文類型：類實驗性研究。