原发性PICC导管异位原因分析与护理对策  

Cause analysis and nursing management of the primary displacement of peripherally inserted central catheter

作　　者：李云[1] 朱色 LI Yun;ZHU Se(Department of Hematology,Haimen People's Hospital,Haimen,Jiangsu,226100)

机构地区：[1]江苏省海门市人民医院血液科,江苏海门226100

出　　处：《中西医结合护理（中英文）》2018年第2期149-151,共3页Journal of Clinical Nursing in Practice

摘　　要：目的探讨经外周静脉穿刺中心静脉置管(PICC)导管异位的原因与护理对策。方法收集2016年1月—12月行PICC置管的肿瘤、血液病行化疗的105例患者的临床资料,其中导管异位11例,分析其置管静脉、置管方式、患者体位与导管异位关系,并通过文献查阅给予相关护理对策。结果置管105例中发生异位11例,异位率10.48%,其中贵要静脉置管发生8例,头静脉置管发生3例。穿刺血管、置管方式、患者体位、操作者置管过程特殊体验、患者相关措施的执行力与导管异位的关系密切。结论穿刺血管避免头静脉、建议采用B超探查、专业人员置管与维护、置管过程中宣教到位使患者配合良好等措施可减少PICC异位的发生,遇导管异位可以采取改变体位配合呼吸运动等进行调整,PICC异位是可以规避和及时发现、纠正的。Objective To explore the cause of primary displacement of peripherally inserted central catheter(PICC)and to summarize the related nursing countermeasures.Methods To collect the clinical data of 105 patients with PICC for chemotherapy.The cause of 11 cases PICC primary displacement and its relationship with intravenous line,catheterization method and position of patients were analyzed.Related nursing countermeasures were summarized by reviewing the present researches.Results There were 11 cases(10.48%)of PICC primary displacement,in which 8 cases via basilic vein and 3 cases via cephalic vein.The quality of PICC placement is affected by intravenous line,catheterization method,position of patients,operators'experience and patients'compliance to the catheterization.Conclusion In order to reduce the incidence of PICC displacement,nursing countermeasures should be carried out such as avoiding catheterization via cephalic vein,using B-ultrasonography,performing professional PICC maintenance and adequate health education.It is also required to take different posture and breathing exercises under the guidance of medical staff,so as to adjust the displacement of PICC.

关 键 词：经外周静脉穿刺中心静脉置管 导管异位 头静脉 护理对策 B超探查 体位配合 

分 类 号：R473.5[医药卫生—护理学]