Study On The Application And Effect Of Two Kinds Of Sealing Fluid In Preventing PICC Blockage

Objective:This study aimed to compare the effects of two kinds of sealing fluid,normal saline and 10U/ml heparin saline,in preventing PICC blockage,and to provide reference and preliminary evidence for clinical work.Methods:This study was a prospective,randomized,parallel and controlled study.From October 2017 to June 2018,490 patients with non three directional valve single-lumen 4Fr PICC were randomly divided into experimental group(saline group)and control group(heparin group).Flushing:The two groups were washed by pulse flushing with 10ml normal saline.Sealing:The experimental group was sealed with 2ml normal saline under positive pressure,while the control group was sealed with 2ml heparin saline(10U/ml)under positive pressure.During catheter maintenance,two groups of patients used the same infusion connector and the same syringe.The follow-up time was 7-90 days,including hospitalization and home intermission.The incidence of PICC blockage during hospitalization and intermission was compared between the two groups.Results:Among the subjects,34 cases fell off,227 cases were sealed with normal saline,and 229 cases were sealed with 10 U/ml heparin saline.There was no significantdifference in the shedding rate,sex,age,body mass index(BMI),disease diagnosis,catheterization arm,catheterization purpose,PICC type,catheter tip location,follow-up time,hospitalization time and home time between the two groups(P>0.05).There was no significant difference in the total incidence of PICC blockage between the two groups during the follow-up period(P>0.05),the incidence of PICC blockage during hospitalization period(P>0.05).The incidence of PICC blockage in the two groups was statistically significant during the period at home(P=0.024).There was no significant difference in the incidence of catheter-related symptomatic thrombosis and intraluminal thrombosis between the two groups(P>0.05).The material fee of single flushing and sealing with normal saline is 2.79 yuan,flushing with normal saline and sealing with heparin saline is 13.5 yuan.During the follow-up period,the normal saline group saved nearly one month's working time(20 working days)compared with the heparin group.Conclusion:Normal saline and 10U/ml heparin saline used in non three directional valve single-lumen 4Fr PICC sealing,the effect of preventing PICC blockage is basically the same,but lOU/ml heparin saline at home period is more reasonable,even if the maintenance of PICC is completed by professional nurses in venous therapy.10U/ml heparin saline sealing did not reduce the incidence of catheter-related symptomatic thrombosis and intraluminal thrombosis in non three directional valve single-lumen 4FrPICC.Compared with 10U/ml heparin saline,normal saline is more convenient and economical for PICC sealing.It is suggested that normal saline be used for non three directional valve single-lumen 4FrPICC sealing during hospitalization.Sealing with normal saline can reduce the pollution and risk of syringe discharge during drug preparation and sealing,and also reduce the labor cost of nursing staff.