六味通络热奄包预防PICC术后机械性静脉炎的疗效研究  

Clinical Study on Liuwei Tongluo Hot Pack Preventing Mechanical Phlebitis after PICC

作　　者：赵楠[1] 王淑阁[1] 关丽[2] 马芸[1] 李旭[1] 廖娟[1] 胥微[1] 孙丽娟 刘春凤[1] Zhao Nan;Wang Shuge;Guan Li(Xiyuan Hospital,Chinese Academy of Traditional Chinese Medicine,Beijing 100091,China)

机构地区：[1]中国中医科学院西苑医院,北京100091 [2]首都医科大学附属北京中医医院,北京100010

出　　处：《中国中医急症》2019年第12期2146-2148,2166,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：北京中医药科技发展资金项目课题(JJ2016-54)

摘　　要：目的观察六味通络热奄包预防PICC术后机械性静脉炎的临床效果并探讨其机制。方法将200例PICC置管患者按1∶1的比例随机分为实验组和对照组各100例。实验组在实施常规护理的同时,于置管后4~6 h开始应用自制六味通络热奄包在置管侧手臂穿刺处上方5 cm处,沿血管走向热敷,每次20 min,每日2次(间隔大于4 h),连续热敷3 d。对照组应用热水袋外敷,热敷的温度、位置、方法、时间、频率同实验组。每日评定患者静脉情况及穿刺手臂肿胀、疼痛、渗血等早期不适症状,连续观察7 d,并记录。结果实验组仅发生1例静脉炎(1.02%),明显低于文献报道的3%~17%;热奄包组较热水袋组PICC术后穿刺手臂疼痛、肿胀明显减轻,两组比较差异有统计学意义(P <0.05)。结论六味通络热奄包能有效预防PICC术后机械性静脉炎及减轻穿刺手臂疼痛、肿胀等早期不适症状,更优于单纯的热水袋外敷。热奄包价格低廉、安全有效、操作简便。Objective:To observe the clinical efficacy of utilizing Liuwei Tongluo Hot Pack to prevent mechanical phlebitis after PICC. Methods:200 PICC patients were divided into the experimental group and the control group,100 cases in each. In addition to usual care,both groups started intervention 4~6 h after PICC for 20 min twice a day continuously for 3 days. The experimental group received Liuwei Tongluo Hot Pack onto the catheter side of the arm about 5 cm above the puncture point. The control group used hot-water pack instead. Patients’ vein condition and symptoms of the catheter arm including swelling,pain and blooding were detected constantly for 7 days. Results:There was only 1 case of mechanical phlebitis in the experimental group in which the incidence(1.02%)was significantly lower than 3%~17% reported in existed studies. Pain and swelling symptoms were statistically abbreviated in the experimental group than in the control group(P < 0.05). Conclusion:Liuwei Tongluo Hot Pack can effectively prevent the postoperative mechanical phlebitis of PICC and reduce the early discomfort symptoms such as pain and swelling of the puncture arm,which is better than the simple hot water bag external application. The heating bag is cheap,safe and effective,and easy to operate.

关 键 词：静脉炎 中药热奄包 PICC 

分 类 号：R543.6[医药卫生—心血管疾病]