早期干预对血液科肿瘤病人PICC置管后血栓形成的预防效果及预后影响  

Effect of early intervention on the prevention of thrombosis and the prognosis in cancer patients after PICC in the department of hematology

作　　者：刁淑华[1] 易小青[1] 练慧萍[1] 曹建华[1] 

机构地区：[1]深圳市宝安区人民医院新生儿科,广东深圳518104

出　　处：《包头医学院学报》2017年第12期78-80,共3页Journal of Baotou Medical College

基　　金：深圳市科技创新计划课题(2014-109)

摘　　要：目的:探究早期护理干预对外周静脉穿刺中心静脉置管(peripherally inserted central venous catheters,PICC)患者血栓形成的预防效果及预后的影响。方法:选取血液科行PICC置管的肿瘤病人92例,根据其护理方式分为对照组(n=46)和观察组(n=46),对照组采用常规导管维护措施,观察组在对照组基础上加入干预措施。比较两组患者置管前、置管3个月时凝血功能指标D-二聚体(D-D)、纤维蛋白原(FIB)检测结果变化情况,记录其PICC堵管率、血栓形成率、重置管率及相关不良反应臂围增粗、穿刺点红肿、感染、皮温升高、肤色变化、疼痛等发生率的差异。结果:置管3个月时,观察组D-D及FIB水平与置管前比较差异均无统计学意义(P>0.05),对照组上述指标检测结果则较置管前提高(P<0.05),且高于同时间段观察组(P<0.05)。观察组PICC堵管率、血栓形成率及重置管率均低于对照组(P<0.05)。两组患者除穿刺点感染率比较差异无统计学意义(P>0.05)外,观察组臂围增粗、穿刺点红肿、皮温升高、肤色变化、疼痛等置管相关不良反应发生率均低于对照组(P<0.05)。结论:早期护理干预可以降低血液科肿瘤病人PICC置管后血栓形成的风险,减轻其不适症状,促进其预后恢复,需引起重视。Objective ：To explore the effect of early nursing intervention on the prevention of thrombosis and the prognosis in patients undergo- ing peripherally inserted central catheter （PICC）. Methods：92 cases of hospitalized cancer patients undergoing PICC in the department of hematol- ogy in our hospital were selected and divided into the control group （ n = 46） and the observation group （ n = 46） according to the nursing meth- ods. The control group was treated with routine catheter maintenance measures and the observation group was given intervening measures additional- ly. Changes of coagulation function indexes [ D - dimer （ D - D） and fibrinogen （FIB） ] before catheterization and at 3 months after the catheter- ization were compared between the two groups. The tube plugging rate, thrombosis rate, replacement rate and the incidence of related adverse reac- tions （arm circumference thickening, puncture site red and swollen, infection, skin temperature increasing, skin color changes and pain） were compared between the two groups. Results ：3 months after catheterization, there were no obvious chauges in D -D and FIB levels compared with those before catheterization in the observation group （ P 〉 0.05 ） while those in the control group were significantly increased. D - D and FIB lev- els in the control group were significantly higher than those in the observation group at the same time point （ P 〈 0.05 ）. The tube plugging rate, thrombosis rate and replacement rate in the observation group were significantly lower than those in the control group （ P 〈 0.05 ）. There was no significant difference between the two groups in the incidence of puncture site infection （ P 〉 0.05 ）. The incidence rates of catheter - related ad- verse reactions （ arm circumference thickening, puncture site red and swollen, skin temperature increasing, skin color changes and pain） in the ob- servation groups were significantly lower than those in the control group （ P 〈 0.05 ）. Concl

关 键 词：PICC置管 血栓形成 早期检测 早期干预 

分 类 号：R473.73[医药卫生—护理学]