藻酸盐敷料在经外周静脉置入中心静脉导管后穿刺点止血中的对比研究  

A Comparative Study on Hemostasis Effect of Alginate Dressing for Puncture Point Bleeding After Peripheral Insertion of Central Venous Catheter

作　　者：陈雅玫[1] 石新华[1] 张煜[1] 

机构地区：[1]北京大学第三医院肿瘤化疗与放射病科,北京100083

出　　处：《中国微创外科杂志》2017年第7期606-608,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨藻酸盐敷料对于经外周静脉穿刺中心静脉置管(peripherally inserted central catheters,PICC)术后穿刺点的止血效果。方法选取2013年11月~2016年5月在我科超声引导下改良塞丁格技术(modified Seldinger technique,MST)行PICC置管的538例肿瘤患者,其中2013年11月~2015年2月270例为对照组,PICC置管成功后,穿刺点应用无菌纱布+3M透明贴膜固定;2015年3月~2016年5月268例为观察组,置管成功后穿刺点应用藻酸盐敷料+无菌纱布+3M透明贴膜固定。2组置管成功后均按压穿刺点20 min,弹力绷带加压固定24 h。比较2组24 h内、24~72 h穿刺点出血程度(浸血面积<1 cm×1 cm为轻度,1 cm×1 cm及3 cm×3 cm之间为中度,≥3 cm×3 cm为重度)和换药次数。结果观察组穿刺点轻度、中度、重度出血24 h内为分别为232例、34例、2例,24~72 h为242例、25例、1例,对照组为12例、196例、62例和21例、212例、37例,差异有显著性(Z=-18.647、-18.768,P=0.000、0.000)。观察组穿刺点换药0次、1次、2次、≥3次24 h内为分别为232例、33例、3例、0例,24~72 h为242例、25例、1例、0例,对照组为12例、196例、51例、11例和21例、209例、37例、3例,差异有显著性(Z=-18.560、-18.755,P=0.000、0.000)。结论藻酸盐敷料对于超声引导下MST技术行PICC术后穿刺点止血效果满意。Objective To investigate the hemostasis effect of alginate dressing for puncture point bleeding after peripherally inserted central catheter （PICC） by ultrasound-guided modified Seldinger technique （MST）.Methods Between November 2013 and May 2016, 538 cases of cancer in our department underwent PICC, including 270 cases from November 2013 to February 2015 selected as control group （after PICC was successfully placed, sterile gauze and 3M transparent film were used to fix the puncture point） and 268 cases from March 2015 to May 2016 selected as observation group （after PICC was successfully placed, alginate dressing, sterile gauze and 3M transparent film were used to fix the puncture point）.The patients in both groups were given 20 minutes of pressure for puncture point and elastic bandage compression fixation for 24 h.The degree of puncture point bleeding and times of dressing change in 24 h and 24-72 h between the two groups were compared.Results In the observation group, mild, moderate, and severe bleeding was seen in 232 cases, 34 cases, and 2 cases within 24 h, and in 242 cases, 25 cases, and 1 case between 24-72 h, respectively.In the control group, mild, moderate, and severe bleeding was seen in 12 cases, 196 cases, and 62 cases within 24 h, and in 21 cases, 212 cases, and 37 cases between 24-72 h, respectively, with significant differences （Z=-18.647, P=0.000;Z=-18.768, P=0.000）.In the observation group, there were zero, once, twice, and ≥3 times of puncture point dressing change in 232 cases, 33 cases, 3 cases, and 0 case within 24 h and in 242 cases, 25 cases, 1 case, and 0 case between 24-72 h, respectively.In the control group, there were zero, once, twice, and ≥3 times of puncture point dressing change in 12 cases, 196 cases, 51 cases, and 11 cases within 24 h and in 21 cases, 209 cases, 37 cases, and 3 cases between 24-72 h, respectively, with significant differences （Z=-18.560, P=0.000;Z=-18.755, P=0.000）.Conclusion The hemostasis effect of alginate dressing for puncture

关 键 词：经外周静脉穿刺中心静脉置管 包扎方式 藻酸盐敷料 

分 类 号：R473.73[医药卫生—护理学]