循证护理对外科ICU患者中心静脉导管相关性并发症的影响  

Effects of evidence-based nursing on central venous catheter related complications of the patients in surgical ICU

作　　者：张阿宁 郗凌云 刘红 叶妮[4] ZHANG A′ning;XI Lingyun;LIU Hong(Depratment of Hemodialysis,The First Hospital of Xi'an Cuty,Shaanxi,Xi'an 710002,China)

机构地区：[1]陕西省西安市第一医院血透室,710002 [2]陕西省西安市第一医院普外科,710002 [3]陕西省西安市第一医院重症医学科,710002 [4]陕西省西安市第一医院神经外科,710002

出　　处：《河北医药》2019年第2期288-291,共4页Hebei Medical Journal

摘　　要：目的分析循证护理对外科重症监护室(ICU)患者中心静脉导管(CVC)相关性并发症的影响。方法将114例外科ICU行CVC放置导管操作患者作为研究对象,随机分为对照组和干预组,每组57例。对照组给予常规护理,干预组给予循证护理。比较2组CVC相关性并发症(导管断裂或脱出、感染、导管堵塞、局部渗血渗液、心绞痛、心律失常等)的发生情况。结果 114例患者中发生CVC相关性并发症32例(28. 07%)。插管部位和时机与CVC相关性并发症的发生,均无显著相关性(P> 0. 05)。2组患者入住ICU时间及CVC置管时间的比较,差异均无统计学意义(P> 0. 05)。干预组局部渗血渗液、导管相关性感染的发生率较对照组均显著降低(P <0. 05),而2组导管堵塞、导管断裂或脱出、心绞痛及心律失常发生率的比较,差异均无统计学意义(P> 0. 05)。干预组非计划拔管总发生率较对照组显著降低(P <0. 05)。结论实施循证护理模式可有效降低外科ICU患者CVC相关性并发症的发生率,具有良好的临床应用价值。Objective To investigate the effects of evidence-based nursing on central venous catheter(CVC)related complications of patients in surgical intensive care unit(ICU).Methods A total of 114 patients in surgical ICU of our hospital who underwent CVC operation were enrolled as the research objects,who were randomly divided into control group(n=57)and intervention group(n=57).The patients in control group were treated by usual nursing,however the patients in intervention group were treated by evidence-based nursing.The incidences of complications associated with CVC including breakage or extrusion of the catheter,infection,catheter blockage,partial errhysis and infiltrate fluid,angina,arrhythmia were observed and compared between the two groups.Results Among the 114 patients,32 cases occured CVC related complications,with the incidence rate being 28.07%.However there was no significant correlation between the location,timing of intubation and the occurrence of CVC related complications(P >0.05).Moreover there was no significant difference in the admission time of ICU and CVC cathetering time between the two groups(P >0.05).The incidence rates of partial errhysis and infiltrate,catheter related infection in intervention group were significantly lower than those in control group(P<0.05).However there were no significant differences in the incidence rates of catheter blockage,breakage or extrusion of the catheter,angina and arrhythmia between the two groups(P >0.05).The total incidence rate of unplanned extubation in intervention group was significantly lower than that in control group(P<0.05).Conclusion The implementation of evidence-based nursing mode can effectively reduce the incidence rate of CVC related complications of patients in surgical ICU,which has good clinical application value.

关 键 词：循证护理 中心静脉导管 重症监护室 并发症 

分 类 号：R473.6[医药卫生—护理学]