两种透明敷料固定中心静脉导管效果观察与成本比较  

Effect and cost analysis of two kinds of transparent dressings on the central venous maintenance

作　　者：金燕萍[1] 马俊[2] 杨海[3] 唐密[3] Jin Yanping;Ma Jun;Yang Hai;Tang Mi(Geriatrics;Nursing Department;Department of Medical Equipment, Shanghai Sixth Peopled Hospital, Shanghai Jiao TongUniversity, Shanghai, 200233, China)

机构地区：[1]上海交通大学附属第六人民医院老年病科,上海200233 [2]上海交通大学附属第六人民医院护理部,上海200233 [3]上海交通大学附属第六人民医院医学装备处,上海200233

出　　处：《现代临床护理》2018年第3期80-83,共4页Modern Clinical Nursing

基　　金：上海市卫生和计划生育委员会科研基金资助项目;项目编号为201640319

摘　　要：目的比较两种透明敷料在中心静脉导管固定中的效果及成本的消耗。方法选取2017年4月至6月入住上海市某三级甲等医院老年科和重症监护室行单腔中心静脉导管置管的75例患者,按穿刺编号分为实验组38例(单号),对照组37例(双号),置管后实验组和对照组分别采用边框型透明敷料、普通透明敷料固定导管,正常每周更换1次敷料,如出现穿刺部位不良反应和敷料固定不良及时更换敷料。了解患者置管后非计划性拔管、穿刺部位不良反应和敷料固定不良情况和更换敷料的成本,两组患者置管后共观察28d。结果实验组患者敷料松动卷边和穿刺部位皮炎发生率低于对照组,差异均有统计学意义(P<0.05)。实验组因更换敷料产生的直接成本、间接成本和总成本均低于对照组(P<0.05)。结论在中心静脉导管固定中采用边框型透明敷料,可提高导管固定效果和降低护理人力成本及医疗成本消耗,值得临床应用推广。Objective To compare the effects and medical cost of 2 kinds of transparent dressings on the central venous catheter maintenance. Methods Selecting 75 patients with single lumen central venous catheter in the Geriatrics and ICU of the Tertiary Hospital during April to June 2017,according to the number of puncture, 38 cases（odd numbers）with bordered transparent dressings were selected as the experimental group, and 37 cases（even numbers） with transparent dressings were selected as control group. The dressings were changed weekly,and will be changed if there＇s rolling edge, dermatitis, seepage and wet. Unplanned tube drawing after 28 days, adverse reaction in the site of puncture, unwell fixed condition of dressings and the related medical costs was evaluated. Results The incidence rate of loosing dressings and dermatitisin the experimental group is significantly lower than those in the control group（P〈0.05）. The direct cost, indirect cost and total cost in experimental group were significantly lower than those in control group（P〈0.05）. Conclusion Bordered transparent dressings can promote the effect of tube fixing and decrease nursing manpower cost and medical cost in central venous catheter maintenance, which can be popularized in clinics.

关 键 词：中心静脉导管 透明敷料 成本效益 

分 类 号：R47[医药卫生—护理学]