19例群体重度烧伤患者静脉通路的护理管理  

Infusion care management of 19 cases of severe batch burns

作　　者：赵锐祎[1] 金静芬[1] 陈春芳[1] 华海平[1] 申屠英琴[1] 李爱萍[1] 江南[1] 

机构地区：[1]浙江大学医学院附属第二医院护理部,杭州市310009

出　　处：《中华护理杂志》2015年第6期709-711,共3页Chinese Journal of Nursing

摘　　要：报告19例群体重度烧伤患者静脉通路的护理。19例患者全身大面积烧伤,外周静脉穿刺困难,中心静脉导管敷料易污染且难固定,其中5例患者静脉穿刺点距烧伤创面小于5cm。烧伤13d出现16例次导管培养阳性,9例次导管相关性血流感染,7例次导管堵塞等问题。通过专人管理,在循证护理的基础上开展多学科合作,应用纱布绷带及缝线联合固定导管,经腋下、腹壁、肩胛下等部位行外周静脉穿刺,经腋静脉中心静脉置管,用肝素和尿激酶预防和处理堵管等方法,成功救治19例患者,导管相关性血流感染维持在11.11%。This paper introduces the management of venous access devices in 19 cases of severe batch bums. Large area burns resulted in difficulty in peripheral venous puncture,risk of dressing pollution of central venous catheters（CVC） and difficulty in fixation of CVC. The distance between puncture site and wound was less than 5cm in 5 cases. Positive results of catheter bacteria cultivation were found in 16 cases at the 13~ day;9 cases suffered from catheter related blood stream infection （CRBSI） and 7 cases suffered from catheter blockage. All cases were successfully cured and the incidence of CRBSI was remained at 11.11% through multi-disciplinary cooperation and evidence-based quality improvement,application of gauze bandage and suture in catheter fixation,insertion of axillary, epigastrie and subscapular accessed peripheral catheters,insertion of axillary vein accessed central catheters,application of heparin and urokinase in the prevention of catheter blockage.

关 键 词：烧伤 输注 静脉内 护理工作 

分 类 号：R473.6[医药卫生—护理学]