742例左右上肢静脉入路PICC患者置管并发症对比分析  

Retrospective Analysis of Complications from 742 Cases of Upper-extremity PICC Insertion

作　　者：陈林敏[1] 李秋梅[1] 范育英[1] 郭少燕[1] 

机构地区：[1]中山大学肿瘤防治中心鼻咽科,广东广州510060

出　　处：《护理学报》2012年第7期66-67,共2页Journal of Nursing（China）

摘　　要：目的指导PICC置管时对左右侧上肢的选择,提高置管患者的日常生活质量,最大限度实现人文关怀。方法回顾性分析742例(左侧311例,右侧431例)上肢PICC患者置管后异位、机械性静脉炎、皮疹、感染以及堵管、断管、裂管和脱管的情况,比较左右上肢PICC置管并发症的发生率。结果左上肢PICC患者置管后无发生堵管、裂管和脱管,局部感染率为1%;右上肢发生堵管、裂管和脱管共6例,局部感染率3.5%,两侧感染率差异有统计学意义(P=0.028);置管后异位、机械性静脉炎和皮疹发生率在两组间差异无统计学意义(P>0.05)。结论左上肢PICC置管并发症发生率低于右上肢;PICC置管术肢的选择,应打破以右侧手臂为首选的传统观念。建议在充分评估患者静脉情况的基础上,顺应患者的生活习惯,选择非惯用手,以提高患者的舒适度、安全感,减少或避免并发症的发生。Objective To guide the patients to determine which upper-extremity to accept peripherally inserted central catheter（PICC）,to maximize humane care and improve the quality of daily life of patients.Methods The complications after PICC insertion,such as catheter displacement,mechanical phlebitis,skin rash,infection,and catheter plugged,broken,cracked and detached were observed from 742（left 311,right 431） upper-extremity PICC inserted patients,and the incidence of these complications were compared between the left and right upper-extremity PICC inserted patients.Results There was no occurrence of catheter plugged,cracked and detached in left upper-extremity PICC inserted patients,but 6 cases in the right side,and the incidence of local infection was lower in the left side inserted patients than that in the right（P=0.028）,but there were no significant difference of the comparison of catheter displacement,mechanical phlebitis and skin rash between both sides（P0.05）.Conclusion The complications of the left upper-extremity PICC inserted patients are much less than those of the right side inserted patients,which indicates that the left arm is the preferred extremity for PICC insertion for Chinese based on fully venous assessment.

关 键 词：PICC 静脉入路 左侧 并发症 

分 类 号：R47[医药卫生—护理学]