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Objective:To construct an evaluation index system for the risk factors of peripheral venous indwelling catheter failure in adults.Methods:Through literature review, focus group interview method and Delphi method, an evaluation index system for risk factors of peripheral venous indwelling catheter failure in adults was established.Results:The recovery rate of the two round were both 100%; the authority coefficient was 0.939, the coordination coefficient was 0.452 and 0.315 respectively ( χ2=607.88, 502.45, P<0.05). Finally an evaluation index system for adult peripheral venous indwelling needle catheter failure risk factors including puncture factors, patient factors, indwelling needle placement factors, indwelling needle maitenance and withdrawal factors and 54 second-level indicators were formed. Conclusions:The construction of adult peripheral venous indwelling needle catheter failure risk factor assessment system is reasonable and comprehensive in content, which provides reference for clinical nurses to evaluate and prevent the failure of adult peripheral venous catheter failure.
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Objective To explore the clinical effect of percutaneous low frequency electric stimulation on prevention of venous indwelling needle thrombotic blockage in patients with coronary heart disease. Methods A total of 150 patients admitted to the department of cardiovascular medicine from May 2017 to January 2018 who met the inclusion and exclusion criteria were selected. It was divided into the intervention group and the control group by the random number table method, including 75 cases in the intervention group and 75 cases in the control group. In the control group, the routine nursing method was adopted for the maintenance of intravenous indwelling needle. In the intervention group, on the basis of routine nursing, the percutaneous low frequency electrical stimulation was added. The incidence of thrombosis, occlusion, mean retention time, patient satisfaction and intravenous infusion complications were compared between the two groups. Results The incidence of thrombosis was 40.0% (30/75) and 64.0% (48/75) in the intervention group and the control group, and the blockage rate was 28.0% (21/75) and 52.0% (39/75) in the intervention group and the control group, respectively. There were significant differences between the two groups (χ2=8.654, 9.000, all P< 0.01). The incidence of phlebitis, drug exosmosis and subcutaneous bruising were 13.33% (10/75), 13.33% (10/75) and 18.67% (14/75) in the intervention group, 33.33% (25/75), 40.00% (30/75) and 41.33% (31/75) in the control group, respectively. There were significant differences between the two groups (χ2=8.385, 13.636, 9.175, all P<0.01). The indwelling time and patient satisfaction of the intervention group were (2.817 ± 0.221) d and 82.67% (62/75) respectively, while those of the control group were (2.291±0.127) d and 50.67% (38/75), respectively. There were significant differences between the two groups (t=17.926, χ2=17.280, all P<0.01). Conclusions Percutaneous low frequency electrical stimulation has positive significance for improving the formation of thrombus at the point of intravenous indwelling needle and preventing the blockage of catheter caused by thrombosis.
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Objective@#To explore the clinical effect of percutaneous low frequency electric stimulation on prevention of venous indwelling needle thrombotic blockage in patients with coronary heart disease.@*Methods@#A total of 150 patients admitted to the department of cardiovascular medicine from May 2017 to January 2018 who met the inclusion and exclusion criteria were selected. It was divided into the intervention group and the control group by the random number table method, including 75 cases in the intervention group and 75 cases in the control group. In the control group, the routine nursing method was adopted for the maintenance of intravenous indwelling needle. In the intervention group, on the basis of routine nursing, the percutaneous low frequency electrical stimulation was added. The incidence of thrombosis, occlusion, mean retention time, patient satisfaction and intravenous infusion complications were compared between the two groups.@*Results@#The incidence of thrombosis was 40.0% (30/75) and64.0% (48/75) in the intervention group and the control group, and the blockage rate was 28.0% (21/75) and 52.0% (39/75) in the intervention group and the control group, respectively. There were significant differences between the two groups (χ2=8.654, 9.000, all P< 0.01). The incidence of phlebitis, drug exosmosis and subcutaneous bruising were 13.33% (10/75), 13.33% (10/75) and 18.67% (14/75) in the intervention group, 33.33% (25/75), 40.00% (30/75) and 41.33% (31/75) in the control group, respectively. There were significant differences between the two groups (χ2 = 8.385, 13.636, 9.175, all P< 0.01). The indwelling time and patient satisfaction of the intervention group were (2.817±0.221) d and 82.67% (62/75) respectively, while those of the control group were (2.291±0.127) d and 50.67% (38/75), respectively. There were significant differences between the two groups (t=17.926, χ2=17.280, all P<0.01).@*Conclusions@#Percutaneous low frequency electrical stimulation has positive significance for improving the formation of thrombus at the point of intravenous indwelling needle and preventing the blockage of catheter caused by thrombosis.
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Objective To explore the curative effects of pulmonary surfactant (PS) injected via venous indwelling needle instead of the endotracheal tube combined with continuous positive airway pressure(CPAP) in the treatment of premature infants with neonatal respiratory distress syndrome (NRDS).Methods 28 premature infants with NRDS were selected,12 cases with gestational age of 28-31 weeks,16 cases with gestational age of 32-34 weeks,and all the cases were treated with PS injected via venous indwelling needle combined with CPAP.The changes in clinical symptoms,blood gas analysis,oxygen saturation,and the parameters of CPAP after treatment were observed.The tracheal intubation in 72h,the second use of PS,respiratory support duration,hospital duration,and the complications between the MIST treatment group and INSURE treatment group were compared.Results There were significant differences in changes of clinical symptoms,percutaneous oxygen saturation,pH,partial pressure of oxyge,partial pressure of carbon dioxide,fraction of inspiration O2 and (positive end expiratory pressure) PEEP after treatment(all P ＜ 0.05).There were statistically significant differences in tracheal intubation in 72h,the second use of PS,complications and respiratory support duration between the MIST group and INSURE group (all P ＜ 0.05).There were no statistically significant differences in bronchopulmonary dysplasia,ROP,PDA,intracranial hemorrhage,and hospital duration (all P ＞ 0.05).Conclusion The therapy of PS injected via venous indwelling needle combined with CPAP in the treatment of premature infants is effective.The method MIST is simple and convenient,has less injury to premature infants,and can reduce frequency and dosage of the PS and respiratory support time.
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Objective To investigate and compare the effect of two kinds of transparent dressings in the use of fixed intravenous indwelling needle in restless patients in emergency first aid. Methods A total of 160 restless patients who were required to use intravenous indwelling needle were randomly divided into conventional dressing group and 3M dressing group by random digits table method, 80 patients in each group. The medical transparent dressings(Specification:6 cm × 7 cm) were used for the patients of conventional dressing group, and 3M dressings(Specification:6.5 cm×7.0 cm ) for 3M dressing group. The fixity time, number of cases intravenous indwelling needle detached, replaced time of transparent dressing, number of crimping cases were compared. Results For the conventional dressing group, fixity time was (19.67 ± 7.02) h, replaced time was (18.92 ± 6.58) h, 15 detached cases and 24 crimping cases happened. While for the 3M dressing group, fixity time was (41.64±17.79) h, replaced time was (41.11 ± 17.76) h, 4 detached cases and 7 crimping cases happened. The difference was statistically significant(t=-10.27,χ2=7.23, t=-10.48,χ2=11.56, all P<0.05). Conclusions 3M transparent dressing is suggested in fixing intravenous indwelling needle in restless patient in emergency first aid. It can ensure the use of intravenous indwelling needle during the period, effectively prevents the needle from detaching due to its good fixation effect.
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Objective To study the effect of clinically applying catheter fixing device to fix indwelling needle in vein. Methods From July to September 2015, 3 725 patients using ordinary transparent dressing to fix the venous indwelling needle for infusion were assigned in the traditional fixed group, while from November 2015 to January 2016, 3 615 patients applying catheter for fixation and using dressing A type ventilation glue to fix intravenous indwelling needle for infusion were taken as a new fixed group. The detachment rate of venous indwelling needle from tube, rate of again paste film change due to the curl of film edge, the incidence of medical adhesive-related skin injury (MARSI), rate of allergy to medical paste, rate of nurse again fixing the tail of the venous indwelling needle and rate of patient satisfaction in two groups were observed. Results The detachment rate of intravenous indwelling needle from tube [0 vs. 0.75% (28)], rate of again changing paste film [1.55% (56) vs. 11.3% (421)], incidence of MARSI [0 vs. 0.72% (27)], rate of allergy to medical paste [0.06% (2) vs. 0.72% (27)], rate of nurse again fixing venous indwelling needle tail [3.54% (128) vs. 57.5% (2 141)] of new fixed group were obviously less than those of traditional fixed group, the difference being statistical significant (all P < 0.05); the rate of patients' satisfaction of new fixed group was significantly higher than that in traditional fixed group [96.0% (3 576/3 725) vs. 78.6% (2 841/3 615),χ2= 98.135, P = 0.015], the difference being statistically significant (P < 0.05). Conclusion Patients using catheter fixation device to fix venous indwelling needle for infusion can protect the blood fluently flowing through the vascular pathway, avoid inducing the occurrence of complications due to poor fixation, reduce the amount of nurse workload and elevate the rate of patients' satisfaction.
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Objective To conduct the contrastive analysis on the indwelling time of fixing indwelling needle by cutting sterile transparent dressing and non-cutting sterile transparent dressing.Methods A total of 236 inpatients in this hospital from August to December 2016 were selected.The patients with odd at last number of admission number served as the experimental group (119 cases),while the patients with even at the last number of admission number served as the control group(117 cases).The indwelling needle type was 18GA,the puncture was once success and the fluid infusion course was more than 5 d.The experimental group used the cutting sterile transparent dressing for fixing the indwelling needle and the extension tube vas completely exposed to the outside of dressing,while the control group adopted the conventional indwelling needle application fixation mode.The blood returning plugging pipe rate,average indwelling time and phlebitis occurrence at 24,48,72,96,＞ 96 h after indwelling needle were recorded.Results The blood returning plugging tube situation at 48,72,96,＞96 h after indwelling needle in the experimental group was superior to that in the control group,the difference was statistically significant(P＜0.05);the average indwelling time in the experimental group was (72.12 ± 3.25)h,while which in the control group was (59.34--3.78) h,and the difference was statistically significant (P＜0.05).Seven cases of phlebitis occurred in the experimental group and 9 cases in the control group,the difference was not statistically significant(P＞0.05).Conclusion Applying cutting sterile transparent dressing for fixing the indwelling needle reduces the plugging pipe rate due to returning blood coagulation,extends the indwelling needle use time,increase the patient's satisfaction,moreover does not increase the phlebitis occurrence risk.
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Objective To explore the optimal concentration of heparin sodium solution, which to seal up intravenous indwelling needle, in patients with Ⅳ thrombocytopenia. Methods A total of 90 patients withⅣthrombocytopenia who required intravenous indwelling needle were randomly divided into three groups which namely A, B and C groups with 30 cases each. A group was sealed up the tube of intravenous indwelling needle with 1 ml heparin sodium solution of 6.25 U/ml, B group with 12.50 U/ml and C group with 25.00 U/ml. The change of the platelet count, plasma prothrombin time (PT), activated partial thromboplastin time (APTT), plasma fibrinogen (Fbg) after extubation were observed in three groups and the incidence of blocking up and retention time were compared among three groups. Results The change of the platelet count, PT, APTT, Fbg were showed no statistical significance among three groups (P>0.05). The incidence of blocking up was 66.7%(22/30) in A group , 43.3%(13/30) in B group and 16.7%(5/30) in C group. They were showed statistical significance (χ2=15.000, P < 0.01). Retention time of tube above or equal to 3 days were observed respectively 13 person (43.3%,13/30) in A group, 21 cases(70.0%, 21/30) in B group, 25 patients(83.3%, 25/30) in C group. All above were showed statistical significance (χ2=11.000, P<0.01). Conclusions Heparin sodium 25.00 U/ml sealing up the tube of intravenous indwelling needle is safe in patient with Ⅳthrombocytopenia, which will reduce the ration of blocking tube and extend the life of tube.
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Objective To investigate the clinical effect of axillary vein puncture needle technique in the infusion of low birth weight infants.Methods The study group received axillary venipuncture indwelling needle technique, the control group was given head intravenous indwelling needle technique, compared the related anomalies incidence of two groups of low birth weight infants during intravenous infusion catheter. Results The incidence of abnormal occlusion, phlebitis, oozing of blood in preterm infants with low birth weight infants (2.13%,4.26% and 2.13%) were significantly lower than those in the control group (19.15%,27.66%,17.02%), respectively (P＜0.05). Conclusion The application of axillary vein puncture needle technique can significantly reduce the incidence of adverse reactions associated with infusion of low birth weight infants, and has positive significance in ensuring the efficacy and prognosis.
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Objective To investigate the effect of psychological intervention and anti-inflammatory and analgesic ointment on phlebitis caused by intravenous indwelling needle. Methods Selected from December 2015 to April 2017 in our hospital treated with intravenous indwelling needle caused by phlebitis patients 96 cases, were randomly divided into control group and study group, each group of 48 cases.The control group received phlebitis caused by intravenous indwelling needle, and the study group received phlebitis, analgesic plaster and psychological intervention in the treatment of phlebitis caused by intravenous indwelling needle. The clinical efficacy of the two groups was recorded. The data were input into SPSS statistical software and analyzed. Results The study group of intravenous indwelling needle induced phlebitis of patients with clinical total efficiency up to 87.50%, total effective rate of the control group was only 70.83%, (P<0.05) data; after treatment, the scores of SDS and SAS scales in the two groups were significantly lower than before, and the negative effect of the study group was better (P<0.05). Conclusion The application of anti-inflammatory analgesic cream combined with psychological intervention can significantly improve the clinical efficacy of phlebitis caused by intravenous indwelling needle, and is conducive to the protection of their quality of life, physical and mental health.
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Objective To investigate the clinical effect of axillary vein puncture needle technique in the infusion of low birth weight infants.Methods The study group received axillary venipuncture indwelling needle technique, the control group was given head intravenous indwelling needle technique, compared the related anomalies incidence of two groups of low birth weight infants during intravenous infusion catheter. Results The incidence of abnormal occlusion, phlebitis, oozing of blood in preterm infants with low birth weight infants (2.13%,4.26% and 2.13%) were significantly lower than those in the control group (19.15%,27.66%,17.02%), respectively (P＜0.05). Conclusion The application of axillary vein puncture needle technique can significantly reduce the incidence of adverse reactions associated with infusion of low birth weight infants, and has positive significance in ensuring the efficacy and prognosis.
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Objective To investigate the effect of psychological intervention and anti-inflammatory and analgesic ointment on phlebitis caused by intravenous indwelling needle. Methods Selected from December 2015 to April 2017 in our hospital treated with intravenous indwelling needle caused by phlebitis patients 96 cases, were randomly divided into control group and study group, each group of 48 cases.The control group received phlebitis caused by intravenous indwelling needle, and the study group received phlebitis, analgesic plaster and psychological intervention in the treatment of phlebitis caused by intravenous indwelling needle. The clinical efficacy of the two groups was recorded. The data were input into SPSS statistical software and analyzed. Results The study group of intravenous indwelling needle induced phlebitis of patients with clinical total efficiency up to 87.50%, total effective rate of the control group was only 70.83%, (P<0.05) data; after treatment, the scores of SDS and SAS scales in the two groups were significantly lower than before, and the negative effect of the study group was better (P<0.05). Conclusion The application of anti-inflammatory analgesic cream combined with psychological intervention can significantly improve the clinical efficacy of phlebitis caused by intravenous indwelling needle, and is conducive to the protection of their quality of life, physical and mental health.
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Objective To study and analyze the effects of two different routes of intravenous administration on mannitol induced phlebitis. Methods 98 patients who received mannitol infusion in the first people's hospital in Wenling from December 2013 to December 2016 were selected as the study objects. The patients were divided into PICC group and peripheral group according to different intravenous administration modes. In group PICC, 49 cases were given intravenous administration by PICC. In peripheral group, 49 cases were received peripheral vein indwelling needle. The incidence of phlebitis in the two groups was compared. Results The data showed that the incidence of phlebitis in group PICC was 8.16%, and the incidence of phlebitis in peripheral group was 22.45%. The difference between the two groups was statistically significant (P<0.05). Conclusion Mannitol infusion by PICC can reduce the incidence of phlebitis.
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Objective:To investigate the effect of warmer intravenous infusion combined with local liquid dressing skin daub methods in short-term PN infusion patients with peripheral venous indwelling needle.Methods:Using the single blind random control method,150 PN patients from October 2015 to August 2016 were included.The control group was given the liquid dressing skin daub with 75 cases,and the observation group was given warmer intravenous infusion jointing local liquid dressing skin daub with 75 cases.To observe the incidence of phlebitis and the pain of the infusion catheter site with the infusion limb and the average maintain time of peripheral venous indwelling needle.Results:The incidence of phlebitis was significantly lower in the observation group than that in the control group (P ＜ 0.01) in two groups.The degree of infusion catheter pain with infusion limb pain wasless painful in the observation group than that in the control group (P ＜ 0.005) in two groups.The degree of catheter site pain after pulling out peripheral venous indwelling needle was less painful in the observation group than that in the control group(P ＜ 0.01) in two groups To compare the average maintain time of peripheral venous indwelling needle was (P ＜ 0.001)in two groups.Conclusion:Warmer intravenous infusion combined with liquid dressing skin daub can effectively prevent the occurrence of phlebitis in patients with peripheral venous indwelling needle PN infusion and improve the comfort.
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Objective To study the application of the two-paths double U-shaped fixer in clinical intravenous indwelling needle fixation. Methods A total of 420 cases using of intravenous indwelling needle from January to June 2015 were involved and divided into experimental group(210 cases) and control group(210 cases) by random digits table method. The two-paths double U-shaped fixer was applied in experimental group and the control group were used tape by Y type to fix. The incidence of returning-blood, blocking, phlebitis, slippage and the comfort between two groups were observed and compared. Results The incidence of returning-blood, blocking, phlebitis, slippage in experimental group were 6.2%(13/210), 0.5%(1/210), 0 , which were lower than those in control group 48.6%(102/210), 5.7%(12/210), 1.4%(3/210) seperately, the differences were statistically significant (χ2=117.895, P<0.01). The incidence of phlebitis levelⅠ,Ⅱ,ⅢandⅣin experimental group were 3.3%(7/210), 1.4%(3/210), 0.9%(2/210), 0, which were lower than those in control group 11.9%(25/210), 9.0%(19/210), 3.8%(8/210), 2.4%(5/210), the differences were statistically significant(Z=-5.960, P<0.01). The incidence of the comfort level 1, 2, 3 and 4 in experimental group were 92.4%(194/210), 6.2%(13/210), 1.4%(3/210), 0 individually, which were higher than those in control group 36.7%(77/210), 46.7%(98/210), 12.4%(26/210), 4.3%(9/210), the differences were statistical significant (Z=-16.228, P < 0.01). Conclusions Two-paths double U-shaped fixationis is better than Y-shaped tape fixation. To compare the venous indwelling needle fixation, two-paths double U-shaped fixer could fix more effectively and safety. At the same time, it also has advantages in convenient, observation and appearance. It could be widely used in clinical practice.
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Objective To investigate the application effect of indwelling needle puncture in the axillary vein of newborn infants.Methods From September 2015 to February 2016,the venous indwelling needle puncture was given for neonatal transfusion 180 cases,including 90 cases of the axillary vein indwelling needle infusion in the experimental group,and 90 cases of puncture of extremity vein infusion in the control group.The application effect of the 2 groups was compared.Results There were significant differences in terms of indwelling needle shedding,phlebitis,drug extravasation,lien time between the experimental group and the control group (P ＜ 0.05) Conclusions During neonatal indwelling needle puncture infusion process,the axillary vein indwelling needle infusion can prevent the indwelling needle shedding,decrease the incidence of phlebitis and reduce the incidence of drug extravasation,and can prolong the indwelling time.Puncture in the simple operation easy,is easy to learn and no need for special facilities and equipment,only conventional intravenous infusion required material,plus 24g indwelling needle,aseptic transparent dressing,paper tape,economical and practical,suitable for application in neonatal ward.
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Objective To investigate the cognition level of clinical nurses to peripheral venous indwelling needles, and provide a reference for nursing administrators to carry out targeted intravenous catheter standardized training operation. Methods By convenience sampling, 129 clinical nurses of the certain grade A class three hospital were selected, and their perception about indwelling intravenous catheter were investigated by using self-designed questionnaire in November 2015. Results 125 questionnaires were effectively rewnered. Average score of 125 nurses′cognition to indwelling intravenous catheter was (57.52 ± 10.23) points, pass rate was 65.6%(82/125), and influencing factors were education background, the job tittle, work experience and so on. Conclusions The clinical nurses′assessment, cognition and knowledge master to indwelling intravenous catheter is not ideal, lacking a comprehensive clinical peripheral venous catheter assessment tools. Clinical nurse managers should focus on strengthening vein management, reasonable and better trained clinical nurse intravenous catheter cognitive level, so as to ensure that the effect of catheter using.
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Objective To identify the success rate of peripheral indwelling needle puncture in pediatric patients, and analyze its influencing factors. Methods A survey was conducted in a sample of 902 pediatric patients.Personal information table of pediatric patients who receive infusionwas adopted to collect data. Results The success rate of first puncture was 85.37%(770/902), the success rate of two punctures was 95.34%(860/902). The success rate was affected by several factors, such as department, ages of the patients, condition of the veins, years of working as a nurse(OR=1.128, 2.308, 2.351, P <0.05). Conclusions Success rate of peripheral indwelling needle puncture in children still can be improved. When formulate management program, the influencing factors should be considered for management standard.
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Objective To investigate the application effect of the puncture method of indwelling needle by single hand in clinical attendance of pediatrics. Methods From March 2015 to September 2015,578 patients in our pediatrics were randomly and equally divided into two groups. The experiment group were treated with the puncture method of indwelling needle by single hand and the control group received traditional puncturing method. Results There were statistical significances in the success rate of first puncture,degree of comfort,sense of pain,dropping of the indwelling needle,phlebitis,exosmosis of drugs and indwelling time of patients between the two groups(P< 0.05). Conclusion In the process of using indwelling needle in pediatrics,the application of the puncture method of indwelling needle by single hand could improve the success rate of first puncture of venous retention needle,enhance the comfort degree of neonates,relieve the sense of pain,reduce the dropping of the indwelling needle,incidence of phlebitis and exosmosis of drugs,and prolong the indwelling time. The operation of this puncture is simple and easy to do and to learn,without any special equipment. In the venous puncture,the only necessities are 24G retention needle,3M indwelling needle and adhesive tape. Obviously,it is economical and practical,and is suitable for application in clinic.
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Objective To explore and study the anti reflux type indwelling needle in patients with neurologi-cal department of internal medicine .Methods 100 cases of hospitalized patients with neurological department of in-ternal medicine between 2014.1~2014.12 in our hospital, were randomly divided into two groups according to the admission number .50 cases of control group with general retaining needle , and group 50 cases by anti reflux type in-dwelling needle .Retention time and related complications were compared in the two groups of patients .Results The retention time with indwelling needle time was 3.7 ±1.7d, which was significantly higher than the control group (2.8 ±1.3d), with significant difference (p0.05), but in the needle blood study group of reflux , plugging rate of Guan Fasheng were significantly lower than that of the control group , with significant difference ( p<0.05) .Conclusion Anti reflux type can effec-tively prolong the indwelling time , reduce part of indwelling needle related complications , and improve the treatment of security, which is worthy of clinical popularization and application .