肿瘤患者PICC拔管各种并发症相关影响因素的临床分析  

Clinical analysis for the influencing factors on PICC extubation in patients with cancer

作　　者：张欣[1] 朱玉欣[1] 刘富德[1] 刘朝兴[1] 尹欣欣[1] 张聪聪 ZHANG Xin;ZHU Yuxin;LIU Fude(Department of Oncology,The First Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市第一医院肿瘤二科,050011

出　　处：《河北医药》2019年第2期300-303,共4页Hebei Medical Journal

基　　金：河北省医学科学研究指令性课题(编号:20150166)

摘　　要：目的探讨肿瘤患者经外PICC拔管出现的各种并发症及处理措施。方法选取主动拔管或被动拔管84例肿瘤患者,拔管前患者签署知情同意书,采用彩色多普勒超声筛查上肢静脉血管血栓形成情况,预测拔管可能出现的问题,分析肿瘤患者PICC拔管困难相关影响因素,规范拔管流程,观察拔管后的并发症,采取相应的处理措施。结果经统计84例拔管的肿瘤患者,计划拔管66例占78. 57%,非计划拔管18例占21. 43%,其中出现不能处理的并发症14例; 84例拔管的肿瘤患者中出现拔管相关的并发症18例(21. 43%)。结论 PICC对于肿瘤患者的治疗非常重要,但由于出现各种不能处理的并发症而拔管,使PICC不能发挥其应有的作用。另外,由于导管留置时间长,可能出现各种拔管相关并发症。通过分析导管留置期间及拔管出现的问题,规范导管维护及拔管操作,以其做到安全使用及撤出PICC,减少PICC相关并发症。Objective To investigate the various complications and treatment measures of PICC extubation in patients with cancer.Methods A total of 84 patients with tumor who underwent active extubation or passive extubation in our department were enrolled in the study.Before extubation the patients signed informed consent.The condition of thrombosis in upper limb venous was detected by color Doppler ultrasound to predict the possible problems after extubation,and the influencing factors on PICC extubation in patients with cancer were nalyzed,and the extubation process was standardized.Moreover The complications after extubation were observed,and the corresponding treatment measures were taken.Results Among 84 patients who underwent extubation,66 patients were planned to be extubated,accounting for 78.57%,18 patients were unplanned extubation,accounting for 21.43%,in whom,there were 14 cases with complications that were difficult to be treated,and 18 patients had complications related with extubation,accounting for 21.43%.Conclusion PICC plays an important role in the treatment of cancer,it is nessesary to standardize the catheter maintenance and extubation operation,to use and withdraw PICC safely in order to reduce the PICC-related complications.

关 键 词：肿瘤患者 PICC拔管 计划拔管 非计划拔管 拔管并发症 

分 类 号：R473.73[医药卫生—护理学]