癌症病人常用中心靜脈導管臨床照護指引

Clinical Practice Guideline: Care and Maintenance of Central Venous Access Device in Cancer Patients

10.6880/TJON.201112/SP_11.03

張黎露(Li-Lu Chang)；張瀞文(Ching-Wen Chang)；周文珊(Wen-Shan Chou)；林思岑(Szu-Chen Lin)

癌症 ； 中心靜脈導管 ； 指引 ； cancer ； central venous access device ； guideline

腫瘤護理雜誌

11卷增訂刊（2011 / 12 / 01）

15 - 40

繁體中文

癌症病人在治療期間通常需要一條可靠的中心靜脈導管以幫助病人接受各項治療，像是化學治療、一般點滴、抗生素，全靜脈營養或輸注血品等，其中化學治療藥物（尤其是起皰性化學治療藥物）和全靜脈營養須經由中心靜脈導管給予以避免萬一藥物外滲時所造成的嚴重傷害。本指引針對台灣癌症病人常用的三種型態的長期導管包括Port-A®、Hickman®導管、和PICC，搜尋近十年的國內外文獻以及照護指引，經過系統性的評選，找出最新而且有實證根據的資訊，加以歸納整合，根據護理人員熟悉的護理過程書寫以期貼近臨床照護工作，成為一份容易閱讀和查詢的指引，以提高臨床的實用性。本指引的建議除了經過系統性的查證之外並且經過國內專家的共識，本指引清楚列出對於照護的建議並且也解釋各項建議的內容。由於第一線醫護人員都可能提供導管照護，因此本照護指引同時也可以提供建議給其他醫療團隊的成員做為病人照護時決策的參考。

Cancer patients often need a reliable central venous access device (CVAD) to receive infusion therapies such as chemotherapy, antibiotics, total parental nutrition (TPN), blood component therapy, etc. Using extensively peer reviewed statements and recommendations that are supported by literature, we devised a guideline to provide evidence-based support for nurses related to the care and maintenance of CVADs (i.e., implanted ports, Hickman catheters and peripherally inserted central catheters), as well as client education and safety. The guideline uses an algorithm organizing the information necessary for clinical decision making, including patient assessment, device selection, implementation of prevention measures, and the care and maintenance of catheters. The guideline is intended to provide the health care professional with a functional action plan to assist in decision making for individualized patient care.

1. 王曉婷(2017)。血液腫瘤住院病人血流感染危險因子之相關性探討。中山醫學大學護理學系學位論文。2017。1-99。