血液透析患者永久性双腔导管的操作流程改良  

Process improvement in managing permanent double-lumen catheters for hemodialysis patients

作　　者：朱高峰[1] 黄行芝[1] 马春玲[1] 徐丹丹[1] 杨举红[1] 

机构地区：[1]荆门市第一人民医院血液净化科,湖北荆门448000

出　　处：《护理学杂志》2013年第13期49-50,共2页

摘　　要：目的探讨永久性双腔导管的操作流程改良对预防透析导管堵管和感染的效果。方法将透析中心置入长期透析导管的21例患者,随机分对照组10例按照2010版血液净化标准进行导管使用和护理,观察组11例强化双腔导管的细节管理,即整个操作过程不让血液在导管内停留,同时操作环节没有导管口的暴露机会。结果对照组1 200个导管日,导管不全堵塞71例次,完全堵塞12例次,感染6例次;观察组1 200个导管日,导管不全堵塞11例次,完全堵塞2例次,感染0次,两组比较,差异有统计学意义(P<0.05,P<0.01)。结论在导管使用和维护中,注重细节管理,可有效防范导管护理不良事件的发生。Objective To explore the effect of caring process improvement in managing permanent double-lumen catheters on rates of occlusion and infection associated with the use of the catheters among hemodialysis patients.Methods Totally,21patients who carried a permanent double-lumen catheter for hemodialysis were divided into two groups：10cases in the control group received management and nursing care according to the 2010Blood Purification Standard Operating Procedure,while 11cases in the observation group additionally received detailed management of the permanent double-lumen catheters：specifically,the retention of blood in the catheters was avoided through the whole process,and the tips of the catheters were not exposed to the air.Results The control group had 71partial occlusions,12complete occlusions,and 6infections,versus 11partial occlusions,2complete occlusions,and 0infection in the observation group,each group totaling 1 200catheter days.The differences between the 2groups were statistically significant（P0.05,P0.01）.Conclusion Detail management of permanent double-lumen catheters for hemodialysis patients helps prevent catheter-related adverse events.

关 键 词：血液透析 永久性双腔导管 细节管理 导管堵塞 导管相关感染 

分 类 号：R473.5[医药卫生—护理学]