一例PICC无症状血栓致拔管困难患者的间歇拔管护理  

Intermittent extubation nursing care of a patient with PICC asymptomatic thrombosis and difficult extubation

作　　者：江南[1] 赵锐祎[2] 张益曼 Jiang Nan;Zhao Ruiyi;Zhang Yiman(Department of Intravenous Therapy Speciality,Second Affiliated Hospital of Medical College of Zhejiang University,Hangzhou 310009,China;Department of Urology Surgery,Second Affiliated Hospital of Medical College of Zhejiang University,Hangzhou 310009,China)

机构地区：[1]浙江大学医学院附属第二医院静脉治疗专科,杭州310009 [2]浙江大学医学院附属第二医院泌尿外科,杭州310009

出　　处：《中国实用护理杂志》2019年第35期2784-2787,共4页Chinese Journal of Practical Nursing

摘　　要：目的 探讨总结1例因PICC无症状血栓导致导管拔除困难患者的护理.方法 通过观察局部与全身情况、心理测试、胸部X线定位、血管超声,运用评判性思维,分析拔管困难的原因;经过积极抗凝及溶栓治疗,间歇拔除导管;拔管后做好延续护理.结果 实施上述护理措施后,24 h内间歇拔除导管,拔管后3个月随访血管超声,显示血管内血栓完全机化.结论 临床中遇PICC拔除困难时,不可强行拔管,先分析原因,并实施正确的护理措施,可以提高拔管成功率.Objective To discuss and summarize the nursing care of a patient with difficult extubation due to asymptomatic thrombosis of PICC.Methods By observing the local and global conditions,psychological tests,chest X-ray localization and vascular ultrasound,using critical thinking,the causes of difficult extubation were analyzed;after active anticoagulation and thrombolytic therapy,intermittent extubation of PICC;after extubation,continuous nursing was done.Results After the above nursing measures were implemented,PICC was removed intermittently within 24 hours,and after 3 months vascular ultrasound was showing that the thrombus in the blood vessel had been completely organized.Conclusion When we encounter difficulties in PICC removal,it is not necessary to extubate the PICC forcibly.It is necessary to analyze the causes and implement correct nursing measures to improve the success rate of extubation.

关 键 词：导管插入术 中心静脉 无症状血栓 拔管困难 护理 

分 类 号：R47[医药卫生—护理学]