血液病患者外周静脉留置针不同留置部位的效果观察  

Effect of Peripheral Intravenous Catheter at Different Sites in Hematological Patients

作　　者：钟慧群 张立力[2] 赵洁[1] 柴燕燕[1] 姚晶晶[1] 许汇娟[1] 罗晨玲[2] ZHONG Huiqun;ZHANG Lili;ZHAO Jie;CHAI Yanyan;YAO Jingjing;XU Huijuan;LUO Chenling(Department of Hematology,Nanfang Hospital Affiliated to Southern Medical University,Guangzhou 510515,Guangdong Province,China;School of Nursing,Southern Medical University,Guangzhou 510515,Guangdong Province,China)

机构地区：[1]南方医科大学南方医院血液科,广东广州510515 [2]南方医科大学护理学院,广东广州510515

出　　处：《解放军护理杂志》2019年第6期59-61,共3页Nursing Journal of Chinese People's Liberation Army

基　　金：南方医科大学护理科研专项(Z2016002)

摘　　要：目的探讨血液病患者外周静脉留置针不同留置部位的效果。方法2018年1-9月,便利抽样法选择在南方医科大学南方医院血液科留置外周静脉留置针超过3d的血液病患者为研究对象,观察并分析不同部位的留置时间及并发症发生率。结果共纳入留置针386例次,其中手背留置针190例次,前臂留置针196例次。手背及前臂的留置时间分别为(5.22±2.45)d及(5.65±2.94)d,导管堵塞发生率分别为25.8%及29.6%,液体渗漏发生率分别为5.8%及3.6%,差异均无统计学意义(均P>0.05);而静脉炎发生率分别为46.8%及29.6%,且6例次(3.2%)手背留置针发生意外脱落,前臂则无一例意外脱落,差异均有统计学意义(均P<0.05)。结论血液病患者根据临床指征拔管时,前臂与手背留置针相比留置时间无差异,但静脉炎及导管脱落发生率低,护士应结合患者血管情况、病情等尽量选择前臂为患者置入外周静脉留置针。Objective To explore the effect of different sites of peripheral venous indwelling needle in patients with hematological diseases. Methods From January to September 2018,the patients with peripheral intravenous catheters for more than 3 days were selected and observed,and the indwelling time and the incidence of complications were analyzed. Results A total of 386 cases with indwelling needles were included, including 190 indwelling needles on the back of hand and 196 indwelling needles on the forearm.The indwelling time of the catheters on the back of hand and forearm was 5.22±2.45 days and 5.65±2.94 days,respectively;the incidence of catheter blockage was 25.8% and 29.6%, respectively;the incidence of fluid leakage was 5.8% and 3.6%,respectively.There was no significant difference (all P >0.05). The incidence of phlebitis in patients with IV site on the back of hand and forearm was 46.8% and 29.6%,respectively, and 6 cases (3.2%) had accidental drop of the indwelling needle on the back of the hand,while none of the forearms had accidental drop,the difference was statistically significant (all P < 0.05). Conclusions When patients with hematological diseases are extubated according to clinical indications,there is no difference in the indwelling time between the indwelling sites of forearm and dorsal hand,but the incidence of phlebitis and accidental drop of the indwelling needle is low in the site of forearm.Clinical nurses should select forearm as far as possible to place peripheral venous indwelling needle for patients according to the condition of blood vessels,condition and treatment.

关 键 词：留置针 留置部位 并发症 

分 类 号：R473.55[医药卫生—护理学]