经静脉属支泵入地塞米松溶液治疗PICC机械性静脉炎的效果  

Effect of pumping dexamethasone solution through intravenous branch on PICC mechanical phlebitis

作　　者：詹晓雁[1] 应灵妹[2] 谈伟芬 吴小飞[1] 

机构地区：[1]浙江中医药大学附属第一医院中心静脉置管维护中心,杭州310006 [2]浙江中医药大学附属第一医院护理部,杭州310006

出　　处：《中华现代护理杂志》2017年第25期3219-3222,共4页Chinese Journal of Modern Nursing

基　　金：浙江省中医药科技计划资助项目（2015ZA072）

摘　　要：目的 探讨经PICC穿刺点属支静脉微量注射泵推注地塞米松溶液对PICC致机械性静脉炎的治疗作用.方法 将90例符合标准的患者随机分为试验组（n=45）和对照组（n=45）.试验组在PICC穿刺点下方选择前臂弹性好、暴露明显、无破损、无炎症且易固定,远离关节和肌腱末端的属支静脉进针,通过5.5#头皮针经微量注射泵输注浓度为0.125 mg/ml地塞米松溶液40 ml,输注速度为10 ml/h,1次/d,输注结束即拔针,每日更换进针部位,连续使用3 d.如使用1 d或2 d就治愈,则治愈后即停用.对照组在PICC敷贴上方用毛巾进行湿热敷,3次/d,20 min/次,湿热敷后用喜辽妥软膏涂擦置管侧上臂,连续使用3 d.两组均观察至采取干预措施后第7天.结果 两组患者在治疗机械性静脉炎治愈率和治愈时间上差异均有统计学意义（P〈0.05）.结论 经穿刺点属支静脉微量注射泵推注地塞米松溶液治疗PICC致机械性静脉炎有效率高,可以缓解患者症状,减轻疼痛,且治疗时间较短.Objective To investigate the therapeutic effect of injection of dexamethasone solution on the mechanical phlebitis induced by PICC through a syringe pump on intravenous branch of the PICC puncture point.Methods A total of 90 patients who met the criteria were divided randomly into experimental group （n=45） and control group （n=45）. Patients in the experimental group were injected on the forearm below the PICC puncture point,where was with good elasticity and obvious exposure,without damage or inflammation,easily fixed,and away from joints or end of tendons. 40 ml of dexamethasone solution,with concentration of 0.125 mg/ml,was injected by a syringe pump with scalp needle 5.5#,with an infusion speed of 10 ml/h,1 time/day. For 3 days of continuous use,the needle was withdrawn once the infusion was done,and the injection location was different for each day. If the mechanical phlebitis was cured after 1 day or 2 days of medication,the injection stopped instantly. For patients in the control group,a wet hot towel was compressed above the PICC point, 3 times/day,20 mins/time. After the application,Hirudoid ointment was rubbed on the side of the upper arm where the catheter was injected,3 days of continuous use was conducted. Observation was conducted to both groups until the 7th day after intervention measures were taken.Results There were significant differences in terms of cure rate and cure time between the two groups （P〈0.05） in the treatment of mechanical phlebitis. Conclusions It is highly effective to treat mechanical phlebitis induced by PICC by injection of dexamethasone solution through a syringe pump on intravenous branch of the PICC puncture point,which can relieve symptoms of patients,reduce their pain within a shorter time.

关 键 词：地塞米松 机械性静脉炎 PICC 静脉属支 

分 类 号：R472[医药卫生—护理学]