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作 者:魏素臻[1] 王爱红[1] 李贵新[1] 王福兰[1] 刘慧荣[1]
机构地区:[1]潍坊医学院附属医院,261031
出 处:《中国实用护理杂志》2010年第8期5-9,共5页Chinese Journal of Practical Nursing
基 金:山东省潍坊市科技局鉴定课题(潍科成鉴字2009第393号)
摘 要:目的 探讨恶性肿瘤化疗患者PICC所致静脉炎的相关因素,提供切实可行的预防措施.方法 将163例住院恶性肿瘤首次化疗且首次使用PICC者,置管后观察3个月.出现静脉炎的34例患者列入静脉炎组,未出现静脉炎的129例患者列入对照组.分别进行一般资料调查:性别、年龄、恶性肿瘤类型、有无过敏史、穿刺静脉的选择、是否一次穿刺成功、置管后活动度、置管后是否经常屈肘、出现静脉炎症状的时间、分级分类;实验室指标检测:包括白细胞计数、中性粒细胞绝对值、免疫指标、空腹血糖;采用特质焦虑量表(T-AI)进行情绪状态评定.进行组间病例对照研究.结果 单因素分析表明穿刺静脉、穿刺次数、活动度、穿刺后屈肘、血糖水平、情绪状态与静脉炎的发生存在相关关系.患者性别、年龄、恶性肿瘤类型、过敏体质、免疫功能、白细胞计数、中性粒细胞计数则与静脉炎的发生无关.多因素条件Logistic回归分析结果显示:贵要静脉置入PICC是静脉炎发生的保护因素;反复多次插管、穿刺后过度活动、持续存在的焦虑情绪是发生静脉炎的危险因素.结论 恶性肿瘤化疗患者PICC穿刺静脉的不同、置管过程中反复多次穿刺,置管后经常屈肘、穿刺侧肢体过度活动、高血糖水平和持续存在的焦虑情绪6个因素与静脉炎的发生存在相关关系.在置管前、中、后采取行之有效的预防措施,可减少静脉炎的发生.Objective To investigate the related factors of phlebitis caused by PICC and support effective preventive nursing measures. Methods 163 patients diagnosed as malignant tumor who first used peripherally inserted central catheters (PICC) were recruited. Patients were observed for 3 months. According to the diagnostic criterion of infection, 34 patients with phlebitis were divided into the phlebitis group and others were divided into the control group. All patients were investigated for general information survey :sex, age, tumor type, allergic history,location of inserted vein, one-time success rate,activity after catheter, elbow bending,phlebitis occurred time, grade and type. Laboratory markers:WBC,neutrophils,immune parameters, fasting plasma glucose. Trait anxiety inventory (T-AI)was used for assessment of emotional state. Case-control study between groups was carried out. Results The results of univariate analysis showed that location of inserted vein,times of inserting vein,activity of inserted limb,elbow bending,blood sugar level and emotion were associated with phlebitis. Sex, age, tumor type, allergic history, immune function,WBC,neutrophils were not involved with phlebitis. The results of multivariate logistic regression analysis showed that PICC through basilica vein was the protective factor. Multiple insertions, more activity of inserted limb,durative anxious emotion were the risk factors of phlebitis. Conclusions Different location of vein,times of inserting vein,activity of inserted limb,elbow bending,high blood glucose level and persistent anxious emotion are the risk factors of phlebitis. Taking effective preventive measures before,during, and after PICC can reduce the incidence of phlebitis.
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