不同敷料在血液透析颈内静脉留置导管中的应用效果比较  

Comparison of the effect of different dressings in catheterization of internal jugular vein in hemodialysis

作　　者：王鑫[1] 王媛媛[1] 孙亚南[1] 耿野[1] WANG Xin;WANG Yuanyuan;SUN Yanan;GENG Ye(Blood Put,cation Room,The First Affiliated Hospital of China Medical University,Shenyang,Liaoning 110001,China)

机构地区：[1]中国医科大学附属第一医院血液净化室,辽宁沈阳110001

出　　处：《安徽医药》2018年第8期1542-1544,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨不同敷料在血液透析颈内静脉留置导管中的应用效果。方法选取颈内静脉留置导管的血液透析患者80例,采用抽签法随机分为纱布敷料组和透明敷贴组,每组各40例。在透析结束后,纱布敷料组使用4层纱布覆盖穿刺点,无纺布医用胶布固定;透明敷贴组使用3M透明敷料覆盖并固定穿刺部位,比较两组导管并发症发生率、导管留置时间及患者舒适度。结果两组导管缝合线断裂、穿刺点渗血、敷料松脱、导管滑脱、出口感染和医用胶布相关皮肤损伤等并发症发生率比较,透明敷贴组均明显低于纱布组敷料组,有统计学意义(P<0.05);两组导管留置时间[(23.10±3.29)d比(17.20±3.29)d]和对敷料主观舒适度(22例比10例)比较,透明敷贴组明显优于纱布敷料组,差异有统计学意义(P<0.01)。结论透明敷贴较纱布敷料,舒适性好,可有效减少导管并发症发生和延长导管使用时间。Objective To investigate the effect of different dressings on catheterization of internal jugular vein in hemodialysis. Methods A total of 80 hemodialysis patients with internal jugular vein indwelling catheters were randomly divided into gauze dressing group and transparent dressing group,with 40 cases in each group. After the end of dialysis,the gauze dressing group was covered with 4 layers of gauze covering the puncture point,and the non-woven medical tape was fixed. The transparent dressing group was covered with 3 M transparent dressing and the puncture site was fixed,and the incidence of catheter complications and catheter indwelling time and patient comfort were compared between the two groups. Results The incidences of complications such as fractures of catheter sutures,bleeding at puncture sites,loose dressings,spondylolisthesis,exit infections and skin injury related to medical tapes were compared between the two groups. The transparent application group was significantly lower than the gauze group dressing group,with statistical significance（P〈0. 05）. Catheter retention time [（23. 10 ± 3. 29） d vs.（17. 20 ± 3. 29） d] and dressing subjective comfort（22 vs. 10） of the two groups were significantly higher than those of the gauze dressing group in the transparent application group（P 〈0. 01）. Conclusion Transparent dressing is more comfortable than gauze dressing and can effectively reduce the incidence of catheter complications and prolong the use of catheters.

关 键 词：3M透明敷贴 纱布敷料 颈内静脉置管 并发症 

分 类 号：R472[医药卫生—护理学]