肿瘤化疗患者PICC固定方式的改进与效果观察  

Improvement and effect observation on fixed way of tumor chemotherapy patients with PICC

作　　者：顾菊凤[1] 朱竹华[1] 姚洪芳[1] 刘琼洁[1] 

机构地区：[1]东南大学医学院附属江阴市人民医院肿瘤科, 无锡214011

出　　处：《中华现代护理杂志》2014年第7期758-760,共3页Chinese Journal of Modern Nursing

摘　　要：目的：探讨肿瘤化疗患者PICC 不同固定方式的临床效果。方法选择本院2009年6月-2012年6月首次化疗患者90例采用抛硬币方法随机分成观察组和对照组各45例，观察组采用顺穿刺血管方向摆放法固定，对照组采用传统“S”形摆放法固定。治疗期间观察记录导管的破损情况及导管相关性并发症的发生情况并询问两组患者的满意度和舒适度。结果观察组导管破裂率为4．4％（2/45），低于对照组的20．0％（9/45），差异有统计学意义（χ2＝5．075，P＜0．05）。观察组发生局部渗血1例，明显少于对照组的9例，差异有统计学意义（χ2＝7．200，P＜0．01）；而两组患者发生静脉炎、导管相关性感染、导管阻塞、导管脱出并发症情况比较，差异无统计学意义（P＞0．05）。观察组患者满意度和舒适度评分为（1．02±0．27），（1．32±0．61）分，均低于对照组的（2．16±0．35），（2．45±0．67）分，差异有统计学意义（ t分别为1．173，1．528；P＜0．05）。结论采用顺穿刺血管方向摆放法固定方式，可以减少PICC应用维护过程中的局部渗血，同时可以预防PICC导管破裂和增加患者对PICC的满意度和舒服度。Objective To investigate the clinical effect of different fixed way of tumor chemotherapy patients with PICC .Methods Totals of 90 patients during June 2009 to June 2012 were randomly divided into experimental group and control group , with 45 cases in each group .Experimental group used the puncture vascular direction fixing way ,while control group used the “S” shape traditional fixed method .The breakage of catheter, catheter-related complications, patients ’ satisfaction and comfort of two groups were observed . Results In experimental group , catheter fracture rate was significantly lower than that in control group , and the difference was statistically significant （4.4% vs 20.0%, χ2 =5.075, P=0.024）.Local bleeding occurred cases in experimental group were significantly less than that in control group （1 vs 9,χ2 =7.200,P=0.007）. While phlebitis , catheter related infection , catheter obstruction , the complications such as tube out between two groups, no statistically significant difference was found （P〉0.05）.Experimental group had lower patients ’ satisfaction and comfort scores than control group , and the difference was statistically significant [（1.02 ±0.27） vs （2.16 ±0.35）,（1.32 ±0.61） vs （2.45 ±0.67）, t =1.173,1.528,respectively; P 〈0.05]. Conclusions Using the puncture vascular direction fixing way can reduce the local bleeding of PICC application and maintenance process , at the same time can prevent the PICC catheter fracture and increase patients ’ satisfaction and comfort in clinic .It is worth promoting clinically .

关 键 词：肿瘤 化疗 PICC 固定方式 

分 类 号：R473.73[医药卫生—护理学]