真空静脉采血针头拔出方式对患者及操作者的影响  

Comparison of effect of needle extraction protocols on patients and operators

作　　者：严佳丽 李亚菊 廖琦 YAN Jia-li;LI Ya-ju;LIAO Qi(North Hospital of Huashan Hospital Affiliated to Fudan University,Shanghai 201907,China)

机构地区：[1]复旦大学附属华山医院北院护理部,上海201907 [2]复旦大学附属华山医院北院检验科,上海201907 [3]复旦大学附属华山医院脑外科,上海200031

出　　处：《中华医院感染学杂志》2019年第24期3826-3829,共4页Chinese Journal of Nosocomiology

基　　金：上海市医药卫生科技发展计划基金资助项目(2017923)

摘　　要：目的比较真空静脉采血针头拔出方式对患者及操作者的影响。方法随机选取2016年5月-2018年5月于复旦大学附属华山医院北院护理部进行真空静脉采血的患者1 000例,按照随机数表法,分为试验组和对照组,每组500例。采血完成后,试验组采用右手食指和拇指握针翼下针梗拔针,并增加左手握真空管顺延采血针中间软管螺旋状帮助复位的动作。对照组仅采用右手食指和拇指握针翼拔针的拔出方案。比较两组患者在两种拔针方案下拔针后针头滴血情况、污染操作者的手的次数、拔针时操作者手指触碰穿刺部位的次数、3 d后电话随访患者穿刺部位皮下瘀血的情况。结果试验组患者在拔针后出现的针头滴血2例、污染操作者的手3次、拔针时操作者手指触碰穿刺部位7次、3 d后电话随访穿刺部位皮下瘀血5次,均较对照组少,试验组患者出现疼痛反应26次,较对照组112次少,试验组患者血液反流7次,较对照组41次少,试验组患者使用其拔针方案拔针时护士职业暴露3次,较对照组17次少,差异均有统计学意义(P<0.05)。结论使用右手食指和拇指握针翼下针梗拔针,左手握真空管顺延采血针中间软管螺旋状复位,右手中指和拇指拔出真空管针头的拔出方案可以降低患者针头滴血情况,皮下瘀血、血液反流情况得到改善,护士职业暴露比例降低。OBJECTIVE To observe the impact of the needle extraction protocols on patients and operators. METHODS A total of 1000 patients who underwent vacuum venous blood collection at the Nursing Department of Huashan Hospital affiliated to Fudan University from May to May 20, 2016 were enrolled. The patients were divided into the experimental group and the control group according to the random number table method, with 500 cases in each group. After the blood collection was completed in the experimental group, the operator used the right index finger and the thumb to grasp the needle to remove it, and followed the added operation: the left hand held the vacuum tube and extended the middle of the blood collection needle to help reduce the spiral. In the control group, the needle was extracted by the right index finger and the thumb without the added operation. The occurrence of blood dripping after the needle was pulled, the times of hands polluted of the operator and the times of touching the puncture site when the operator pulled out the needle were compared between the two groups, and occurrence of extravasated blood was recorded by the telephone followed-up 3 days later. RESULTS After the needle was removed, 2 cases of blood dripping, 3 times of hands polluted of the operator, 7 times of touching the puncture site and 5 cases of extravasated blood were found in the experimental group, which were lower than that in the control group. The occupational exposure of nurses in the experimental group was 3 times in the experimental group, which was significantly less than that in the control group(17 times)(P<0.05). CONCLUSION The protocol of using the right index finger and the thumb to pull out the needle and holding the vacuum tube to reset the spiral tube in the middle by the left hand. The extraction procedure, which the right middle finger and the thumb pull out the vacuum tube needle can significantly reduce the occurrence of blood flow of the patient needle and subcutaneous blood of patients. The blood reflux conditi

关 键 词：采血针拔出方案 真空静脉采血 临床表现 

分 类 号：R472[医药卫生—护理学]