中华护理杂志 ›› 2026, Vol. 61 ›› Issue (9): 1157-1162.DOI: 10.3761/j.issn.0254-1769.2026.09.001

• 静脉通路装置留置及维护专题 •    下一篇

中心静脉通路装置拔除护理专家共识

中华护理学会静脉输液治疗专业委员会, 北京护理学会(执笔:李佳1(), 李旭英2, 覃惠英1, 陈利芬3, 吴珍明4, 胡泽吟4, 罗梦娜5, 范育英5, 吴嘉慧6, 林宇萍4, 王蕾7, 孙文彦8, 冯毕龙9, 高伟10, 李亚南11, 侯罗娅12, 李春燕13,*()   

  1. 1 中山大学肿瘤防治中心护理部 广州市 510060
    2 湖南省肿瘤医院护理部 长沙市 410000
    3 中山大学附属第一医院护理部 广州市 510080
    4 中山大学肿瘤防治中心导管门诊 广州市 510060
    5 中山大学肿瘤防治中心鼻咽科 广州市 510060
    6 中山大学肿瘤防治中心日间化疗门诊 广州市 510060
    7 北京医院/国家老年医学中心/中国医学科学院老年医学研究院护理部 北京市 100005
    8 北京协和医院临床营养科 北京市 100730
    9 武汉大学中南医院护理部 武汉市 430071
    10 山东大学齐鲁医院PICC门诊 济南市 250012
    11 郑州大学第一附属医院护理部 郑州市 451191
    12 浙江中医药大学护理学院 杭州市 310053
    13 北京护理学会 北京市 100005
  • 收稿日期:2025-11-07 出版日期:2026-05-10 发布日期:2026-04-30
  • *通讯作者: 李春燕,E⁃mail:lcy_hhh@126.com
  • 作者简介:李佳:女,硕士(博士在读),副主任护师,护理部副主任,E⁃mail:lijia1@sysucc.org.cn

Expert consensus on nursing care of central venous access device removal

Intravenous Infusion Therapy Committee of Chinese Nursing Association, Beijing Nursing Association, (Writing Committee:LI Jia1(), LI Xuying2, QIN Huiying1, CHEN Lifen3, WU Zhenming4, HU Zeyin4, LUO Mengna5, FAN Yuying5, WU Jiahui6, LIN Yuping4, WANG Lei7, SUN Wenyan8, FENG Bilong9, GAO Wei10, LI Yanan11, HOU Luoya12, LI Chunyan13,*(), )   

  1. 1 Department of NursingSun Yat-sen University Cancer CenterGuangzhou 510060, China
    2 Department of NursingHunan Cancer HospitalChangsha 410000, China
    3 Department of Nursingthe First Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510080, China
    4 Department of Catheter ClinicSun Yat-sen University Cancer CenterGuangzhou 510060, China
    5 Department of Nasopharyngeal CarcinomaSun Yat-sen University Cancer CenterGuangzhou 510060, China
    6 Department of Daytime Chemotherapy ClinicSun Yat-sen University Cancer CenterGuangzhou 510060, China
    7 Department of NursingBeijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical SciencesBeijing 100005, China
    8 Department of Clinical NutritionPeking Union Medical College HospitalBeijing 100730, China
    9 Department of NursingZhongnan Hospital of Wuhan UniversityWuhan 430071, China
    10 PICC ClinicQilu Hospital of Shandong UniversityJinan 250012, China
    11 Department of Nursingthe First Affiliated Hospital of Zhengzhou UniversityZhengzhou 451191, China
    12 School of NursingZhejiang Chinese Medical UniversityHangzhou 310053, China
    13 Beijing Nursing AssociationBeijing 100005, China
  • Received:2025-11-07 Online:2026-05-10 Published:2026-04-30
  • * Corresponding author: LI Chunyan,E⁃mail:lcy_hhh@126.com

摘要:

目的 形成中心静脉通路装置拔除护理专家共识(以下简称“共识”),以规范相关临床实践。方法 系统进行文献检索、质量评价与证据整合,并结合实践经验,形成“共识”初稿。于2025年5—7月通过2轮专家函询及2次专家论证会,对“共识”内容进行修订,形成终稿。结果 24名来自广东、广西、福建等14个省份的专家参与了2轮函询。2轮专家函询中,专家的积极系数分别为92.31%、100%,权威系数分别为0.903、0.908,条目重要性评分均数分别为4.04~5.00、3.97~4.90分,变异系数分别为0~0.23、0.06~0.25,肯德尔和谐系数分别为0.202、0.138(均P<0.001)。“共识”包括适用范围、定义、中心静脉通路装置的拔除指征、拔除中心静脉通路装置的注意事项及应急处理措施等内容。结论 “共识”具有科学性和严谨性,可为拔除中心静脉通路装置相关操作提供实践指导。

关键词: 中心静脉通路装置, 静脉血栓形成, 导管相关性感染, 皮炎, 接触性, 专家意见, 护理

Abstract:

Objective To develop an expert consensus on the removal of central venous access devices(hereinafter referred to as the “consensus”) to standardize related clinical practices. Methods A systematic literature search,literature quality evaluation,and synthesis were conducted. Combined with practical experience,an initial draft of the “consensus” was developed. From May to July 2025,the draft underwent revision and refinement through 2 rounds of expert Delphi surveys and 2 expert panel meetings,culminating in the final version. Results A total of 24 experts from 14 provinces/municipalities(Guangdong,Guangxi,Fujian,et al) participated in 2 rounds of Delphi survey,with response rates of 92.31% and 100%. In both Delphi rounds,expert authority coefficients were 0.903 and 0.908,respectively;mean importance scores ranged from 4.04~5.00(round 1) and 3.97~4.90(round 2);coefficients of variation were 0~0.23(round 1) and 0.06~0.25(round 2);Kendall’s W coefficients were 0.202 and 0.138(both P<0.001). This “consensus” covers the scope of application,definitions of key terms,indications for catheter removal,operational precautions,and related emergency management measures. Conclusion The “consensus” is scientific and rigorous,providing practical guidance for the procedures related to the removal of central venous access devices.

Key words: Central Venous Access Device, Venous Thrombosis, Catheter-Related Infections, Dermatitis, Contact, Consensus Statement, Nursing Care