腹盆部肿瘤患者PICC带管院外延续性护理效果研究  

Observation on effect of extrahospital continuous nursing with indwelling PICC in patients with abdominal and pelvic tumor

作　　者：胡小梅[1] 李庆红[1] 卢蓓蕾[1] 胡二 杨占慧[1] 张燕 冷丽娟[1] 冯继红[1] HU Xiaomei;LI Qinghong;LU Beilei;HU Er;YANG Zhanhui;ZHANG Yan;LENG Lijuan;FENG Jihong(Department of Abdominal Tumor,Affiliated Hospital of Zunyi Medical College,Zunyi,Guizhou 563003,China;Hemodialysis Center,Huaxi District People′s Hospital,Guiyang,Guizhou 550025,China)

机构地区：[1]遵义医学院附属医院腹部肿瘤病区,贵州遵义563003 [2]贵阳市花溪区人民医院血液透析中心,贵州550025

出　　处：《现代医药卫生》2018年第16期2441-2444,共4页Journal of Modern Medicine & Health

基　　金：国家自然科学基金资助项目(81560407);遵义医学院附属医院硕士科研启动资金项目(院字[2015]43号)

摘　　要：目的探讨腹盆部肿瘤患者经外周静脉置入中心静脉导管(PICC)带管院外延续性护理的效果。方法选取2014年6月至2017年6月在遵义医学院附属医院腹部肿瘤科住院行PICC带管出院的腹盆部肿瘤患者328例为研究对象,分为对照组(69例)和干预组(259例)。对照组实施一般健康知识宣教护理,干预组在此基础上根据患者具体情况实施医联体、帮扶、微信平台、分阶段电话随访等延续护理,观察分析导管并发症、患者自我管理能力、健康促进生活方式及患者护理满意度,随访时间为6个月。结果干预组患者导管并发症发生率[4.6%(12/259)]明显低于对照组[21.7%(15/69)],差异有统计学意义(χ~2=2.25,P=0.002)。干预组患者导管自我管理能力量表总均分、日常导管观察、维护依从性、导管管理信心、异常情况处理、信息获取、带管日常生活各维度得分均低于对照组,差异均有统计学意义(P<0.05)。在健康促进生活方式中干预组营养、健康责任、压力管理、体育运动、精神成长维度评分均高于对照组,差异均有统计学意义(P<0.05)。干预组患者护理效果满意度[(97.90±1.13)%]明显高于对照组[(93.28±1.51)%],差异有统计学意义(t=-15.082,P=0.000)。结论针对PICC带管出院的腹盆部肿瘤患者开展多形式随访,能提高患者对导管的自我管理能力及健康知识水平,减少导管相关并发症,保障患者导管使用的安全性。Objective To investigate the effect of extrahospital continuous nursing with indwelling peripherally inserted central catheter(PICC)in the patients with abdominal and pelvic tumor.Methods A total of 328 patients with abdominal and pelvic tumor and extrahospital continuous nursing with indwelling PICC in the department of abdominal tumor of the Affiliated Hospital of Zunyi Medical College from June 2014 to June 2017 were selected as the research subjects and divided into the control group(69 cases)and intervention group(259 cases).The control group implemented the general health knowledge education and nursing care,and on this basis the intervention group implemented the continuous nursing mode such as the medical treatment alliance,assist,WeChat platform,grading telephone follow up,etc.The contents included the catheter complications,self management ability,health promoting lifestyle,nursing satisfaction.The follow up lasted for 6 months.Results The incidence rate of catheter complications in the intervention group was 4.6%(12/259),which was significantly lower than 21.7%(15/69)in the control group,the difference was statistically significant(χ2=2.25,P=0.002).The total average scores of catheter selfmanagement ability and dimensional scores of everyday catheter observation,maintenance compliance,catheter management confidence,treatment of abnormal condition,information obtaining and daily living with indwelling PICC in the intervention group were higher than those in the control group,while the maintenance compliance score was lower than that in the control group,the differences were statistically significant(P<0.05).In the health promoting lifestyle mode,the differences were statistically significant(P<0.05).The nursing satisfaction in the intervention group was(97.90±1.13)%,which was significantly higher than(93.28±1.51)%in the control group,the difference was statistically significant(t=-15.082,P=0.000).Conclusion Carrying out the multiform follow up in the patients with abdominal and pelvic tumor and disch

关 键 词：腹部肿瘤 盆腔肿瘤 导管插入术 中心静脉 延续性护理 

分 类 号：R473.73[医药卫生—护理学]