局部麻醉在肿瘤PICC置管患者中的应用  

Study on the effect of local anesthesia in cancer patients with insertion of peripherally inserted central catheters

作　　者：石丽梅[1] 傅桂芬[2] 李丽蓉[1] 梁娟[1] 王婷[1] 班志新 SHI Li-mei;FU Gui-fen;LI Li-rong;LING Juan;WANG Ting;BAN Zhi-xin(Radiotherapy Ward, Clinical Oncology Center, Guangxi Zhuang Autonomous Region People's Hospital, Nanning 530021,China;Department of Nursing, Guangxi Zhuang Autonomous Region People's Hospital,Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院临床肿瘤中心放疗病区,广西南宁530021 [2]广西壮族自治区人民医院护理部,广西南宁530021

出　　处：《黑龙江医药科学》2019年第4期47-49,共3页Heilongjiang Medicine and Pharmacy

基　　金：广西壮族自治区卫生计划生育委员会课题,编号:Z2016642,Z2015338

摘　　要：目的:探讨局部麻醉在超声引导下PICC置入术中的应用效果。方法:将179例在我院临床肿瘤中心住院化疗的PICC置管患者分为观察组和对照组,观察组89例在穿刺前行局部麻醉,对照组90例在扩皮前行局部麻醉。评估两组患者置管过程中的疼痛评分、舒适度评分、一次穿刺成功率、穿刺满意度、机械性静脉炎和静脉血栓的发生率。结果:观察组患者疼痛评分为(1.65±1.35)分,对照组为(4.31±1.28)分,两组比较差异有统计学意义(t=13.541,P<0.05)。观察组患者舒适度评分为(7.63±1.17)分,对照组为(6.54±1.38)分,两组比较差异有统计学意义(t=5.659,P<0.05)。观察组一次穿刺成功有77例,对照组为58例,两组比较差异有统计学意义(χ^2=11.760,P<0.05)。观察组满意+非常满意的有82例,对照组为61例,两组比较差异有统计学意义(χ^2=16.523,P<0.05)。观察组发生机械性静脉炎1例,对照组4例,两组比较差异均无统计意义(χ^2=1.817,P>0.05)。观察组发生静脉血栓1例,对照组发生5例,(χ^2=2.713,P>0.05)两组比较差异均无统计意义。结论:穿刺前局部麻醉与扩皮前局部麻醉所发生的机械性静脉炎和静脉血栓没有差异,但穿刺前局部麻醉可以减轻患者的疼痛,提高患者舒适度、1次穿刺成功率和满意度。Objective: To investigate the application effect of local anesthesia in ultrasound-guided PICC catheterization.Methods: One hundred and seventy-ninepatients with PICC catheterization who were hospitalized in the clinical tumor center of our hospital were selected and divided into observation group and control group.Local anesthesia was performed before puncture in 89 patients in the observation group and before skin enlargement in 90 patients in the control group.Pain score, comfort score, success rate of one puncture, satisfaction with puncture, incidence of mechanical phlebitis and venous thrombosis during catheterization were evaluated in the two groups.Results: The pain score of the observation group was (1.65±1.35), and that of the control group was (4.31± 1.28), and the difference between the two groups was statistically significant (t=13.541,P<0.05). The comfort score of the observation group was (7.63±1.17), and that of the control group was (6.54±1.38). The difference between the two groups was statistically significant (t=5.659,P<0.05). There were 77 cases of successful puncture in the observation group and 58 cases in the control group, and the difference between the two groups was statistically significant (χ^2=11.760,P<0.05). There were 82 cases of satisfactory and very satisfactory in the observation group and 61 cases in the control group, and the difference between the two groups was statistically significant (χ^2=16.523,P<0.05). Mechanical phlebitis occurred in 1 case in the observation group and 4 cases in the control group, and there was no statistical difference between the two groups (χ^2=1.817, P>0.05). There was 1 case of venous thrombosis in the observation group and 5 cases in the control group, and there was no statistical difference between the two groups (χ^2=2.713,P>0.05). Conclusion: There is no difference between the mechanical phlebitis and venous thrombosis caused by local anesthesia before puncture and that caused by local anesthesia before exfoliation, but local anesthes

关 键 词：PICC 局部麻醉 效应分析 

分 类 号：R614.3[医药卫生—麻醉学]