비턴넬형 중심정맥관 개방성 유지를 위한 헤파린 희석액관류와 생리식염수 관류의 비교
Comparison of Heparin Solution and 0.9% Normal Saline Solution Flushing to Secure the Patency of NonTunneled Central Venous Catheters
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Backgrounds: 심부정맥혈전증(Deep Vein Thrombosis,. DVT)은 폐색전증(Pulmonary Embolism, PE)등과 같은 치명적인 질환의 원인으로 장기간의 부동이나 수술, 마비, 외상 등에 의해 발생한다. 본 연구는 다양한 위험요인을 가진 외과환자들에게 사용할 수 있는 근거기반의 심부정맥혈전증 예방 실무지침을 수용개작하여 국내 간호현장에서 유용하게 사용하고 심부정맥혈전증 예방에 기여하고자 한다. Methods: 2012년 구 등이 개발한 “간호분야 실무지침 수용개작”방법론 에 근거하여 24단계의 수용개작과정을 진행하였다. Results: 본 연구에서 수용 개작된 심부정맥혈전증 예방을 위한 권고안은 8개 영역의 79개 권고안으로 구성되었다. 권고안에 대해 근거강도와 근거등급을 평가하였고 배경지식도 제시하였다. Conclusion: 수용개작 된 심부정맥혈전증 예방지침은 간호실무의 기초를 위한 근거기반 실무지침에 추가되었다. 앞으로 수용개작된 심부전맥혈전증 예방 가이드라인이 적극적으로 활용할 수 있도록 확산과정이 필요하다.
Abstract
Purpose: The purpose of this study was to compare the effectiveness of heparin and 0.9% normal saline solutionflushing for maintaining patency of nontunneledcentral venous catheters in patients with surgery. Methods:A randomized controlled clinical trial was performed. Fiftyeightpatients were prospectively enrolled andfifty-four patients were completed the study. The heparin group consisted of 30 patients given 100u/ml dilutedheparin flushing and the normal saline group consisted of 24 patients with 0.9% sodium chloride flushing. Results: There was no significantly difference in occlusion between the heparin group and the normal salinegroup in nontunneledcentral venous catheters’ occlusion. Also there was no difference between these twogroups in catheterrelatedinfections. Conclusion: Flushing with 0.9% normal saline is as effective as flushingwith heparin solution in maintaining the patency of nontunneledcentral venous catheters. In this study,however, the duration of central line use was short and the infection occurrence was little. Further studies arewarranted with a larger sample size at multiple centers.
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