呼吸配合在减少PICC置管异位中的应用  

Application of breathing coordination in reducing catheter tip malposition during PICC inserting

作　　者：袁丽[1] 陆勤美[2] 王翠兰[3] 许容芳[2] 

机构地区：[1]南通市肿瘤医院PICC置管中心,江苏省南通市226361 [2]南通市肿瘤医院护理部,江苏省南通市226361 [3]南通市肿瘤医院内科,江苏省南通市226361

出　　处：《中华护理杂志》2014年第4期498-502,共5页Chinese Journal of Nursing

基　　金：2013年度南通市社会事业科技创新与示范项目(编号:HS13919)

摘　　要：目的探讨恰当的呼吸配合对减少PICC置管术中导管异位的效果。方法选择250例需行PICC置管治疗的肿瘤患者,随机分为观察组127例、对照组123例,对照组采用常规PICC置管操作,观察组将常规置管操作中的患者侧头配合改为呼吸配合,术后统计PICC异位部位及对应例数,对比组间异位发生率。结果共发生16例导管异位,观察组2例,发生率1.57%;对照组14例,发生率11.38%;两组异位发生率差异有统计学意义(χ2=10.033,P<0.01),其中两组颈内静脉异位、腋静脉异位发生率差异有统计学意义(χ2=4.850、4.197,P均<0.05),两组胸廓内静脉异位、奇静脉异位、锁骨下静脉返折发生率差异无统计学意义(P均>0.05)。结论 PICC置管操作中,患者恰当的呼吸配合可显著降低术中导管异位发生率,对降低颈内静脉异位、腋静脉异位的效果突出。Objective To evaluate the effect of breathing coordination in reducing catheter tip malposition during PICC inserting. Methods Totally 250 cancer patients receiving PICC were randomly assigned to two groups. The control group（n=123） received routine care during PICC inserting,while the experimental group（n=127） received breathing coordination guidance instead of turning head coordination. The incidence and sites of PICC malposition were compared between the two groups. Results The total incidence of PICC malposition in the experimental group was significantly lower than that of the control group（1.57% vs 11.38%,X^2=10.033,P=0.002）. Significant dif-ferences were found in the incidences of malposition in internal jugular vein and axillary vein between the two groups（P〈0.05） ,while no significant differences were found in the incidences of malposition in internal thoracic vein,azygos vein and folding back in subclavian vein between the two groups（P〉0.05）. Conclusion Patients＇ appro-priate breathing coordination can reduce the incidence of catheter tip malposition during PICC inserting,especially in reducing the incidence of malposition in internal jugular vein and axillary vein.

关 键 词：呼吸 导管插入术 中心静脉 异位 

分 类 号：R472[医药卫生—护理学]