社区护士经外周静脉置入中心静脉导管专项技能培训对提高肿瘤患者化疗间歇期留置导管社区护理效果的作用  

Effect of community nurse training in peripherally inserted central catheter on nursing quality of tumour patients with indwelled catheter during intermission of chemotherapy

作　　者：唐文凤[1] 王显平[1] 

机构地区：[1]重庆医科大学附属第一医院胸心外科,400016

出　　处：《中华临床营养杂志》2014年第6期376-380,共5页Chinese Journal of Clinical Nutrition

基　　金：重庆市渝中区科技计划项目（20120302）

摘　　要：目的 评价社区护士经外周静脉置入中心静脉导管（PICC）专项技能培训对提高化疗间歇期PICC维护质量的效果.方法 选取重庆医科大学附属第一医院胸心外科2011年9月至2013年3月留置PICC的220例食管癌或肺癌患者,其中男174例（79.1％）、女46例（20.9％）,年龄为（61.1±9.0）岁.以社区护士参加PICC技能专项培训时间为界限,将患者分为培训前组（n=119）和培训后组（n=101）.比较两组患者在化疗间歇期PICC相关并发症发生率和患者满意度.结果 社区护理期间PICC总并发症发生率为20.9％ （46/220）,按照发生率高低依次为感染（7.2％,16/220）、静脉血栓（4.5％,10/220）、导管堵塞（3.6％,8/220）、导管脱落（2.7％,6/220）、渗出或损坏（2.7％,6/220）.培训后组PICC相关并发症总发生率和感染发生率均显著低于培训前组（14.9％比26.1％,P=0.047; 3.0％比10.9％,P=0.035）,而患者满意度（对PICC疑问的解答、对手臂上导管及其位置的感受、总体评价）显著优于培训前组（P =0.003、0.011、0.001）.结论 实施社区护士PICC专项技能培训能够提高肿瘤患者化疗间歇期PICC护理效果和患者满意度.Objective To evaluate the effect of community nurse training in peripherally inserted central catheter （PICC） on community nursing quality of tumour patients with indwelled PICC during the intermission of chemotherapy.Methods A prospective study was performed with a total of 220 patients with esophageal or lung cancer enrolled from September 2011 to March 2013 in the Department of Cardiothoracic Surgery,the First Affiliated Hospital of Chongqing Medical University.The 220 patients included 174 males （79.1%） and 46 females （20.9%）,at the age of （61.1 ±9.0） years.With the start of community nurse training as the cut-off line,the patients were divided into pre-training group （n =119） and post-training group （n =101）.PICC-related complications and patient satisfaction were compared between the 2 groups.Results The overall PICC-related complication rate was 20.9% （46/220） during community nursing,including,in the order of declining incidence,infection （7.2%,16/220）,and venous thrombosis （4.5%,10/220）,catheter occlusion （3.6%,8/220）,catheter dropping （2.7%,6/220）,and leaking/damage （2.7%,6/220）.The total complication rate and incidence of infection in the post-training group were both significantly lower than those in the pre-training group （14.9% vs.26.1%,P =0.047 ; 3.0% vs.10.9%,P =0.035）,and patient satisfaction （including satisfaction for answers to questions about PICC,feelings about PICC indwelling and PICC position,and overall satisfaction） was significantly higher than in the pre-training group （P =0.003,P =0.011,P =0.001）.Conclusion Community nurse training programmes have positive effects on improving PICC-related nursing and patient satisfaction in cancer patients with PICC indwelling during intermissions of chemotherapy.

关 键 词：经外周静脉置入中心静脉导管 护理培训 社区护理 化疗间歇期 

分 类 号：R473.73[医药卫生—护理学]