住院患儿静脉输液工具使用及留置现况的调查研究  

Investigation on the application and retention of intravenous infusion tools in hospitalized children

作　　者：王春立[1] 吴旭红[1] 谢鑑辉[2] 聂晓燕 董洁景[4] 吴心怡[1] 王伟[5] 徐群[6] 黄雀兰[7] 张琳琪[1] 刘丽丽[1] Wang Chunli;Wu Xuhong;Xie Jianhui;Nie Xiaoyan;Dong Jiejing;Wu Xinyi;Wang Wei;Xu Qun;Huang Quelan;Zhang Linqi;Liu Lili(Nursing Department,National Center for Children's Health,China,Beijing Children's Hospital,Capital Medical University,Beijing 100045,China;Nursing Department,Hunan Children's Hospital,Changsha 410007,China;Nursing Department,Inner Mongolia Women and Children's Hospital,Hohhot 010020,China;Nursing Department,Hebei Children's Hospital,Shijiazhuang 050021,China;Outpatient IV Department,Dalian Children's Hospital,Dalian 116012,China;Emergency Department,Jinan Children's Hospital,Jinan 250022,China;PICU,Shenzhen Children's Hospital,Shenzhen 518038,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院护理部,100045 [2]湖南省儿童医院护理部,长沙410007 [3]内蒙古自治区妇幼保健院护理部,呼和浩特010020 [4]河北省儿童医院护理部,石家庄050021 [5]大连市儿童医院门诊部输液科,116012 [6]济南市儿童医院急诊科,250022 [7]深圳市儿童医院PICU,518038

出　　处：《中华现代护理杂志》2020年第1期16-20,共5页Chinese Journal of Modern Nursing

基　　金：福棠儿童医学发展研究中心护理专业委员会静脉输液治疗专业协作组项目。

摘　　要：目的调查住院患儿静脉输液时不同工具的使用情况以及静脉导管留置期间存在的问题,从而为临床提供指导。方法采用方便抽样的方法,于2018年7月24—31日,选择北京儿童医院医联体范围内49家医院的住院患儿静脉输液治疗情况进行调查。应用自行设计的儿童静脉输液情况横断面调查表及拍摄静脉输液工具的照片进行资料收集。采用SPSS 17.0软件进行统计学分析。结果调查期间49家医院共有住院患儿18316例,输液患儿14421例,输液比例为78.73%。静脉导管的应用情况为外周静脉短导管(留置针)占87.94%;静脉导管的连接以肝素帽连接为主,占64.23%,6398例(44.37%)患儿应用的输液工具为聚氯乙烯(PVC)材质且含邻苯二甲酸二(2-乙基)己酯(DEHP);在敷料选择方面以无菌透明敷料固定为主。导管留置期间存在问题主要是导管或输液接头内有回血发生率、导管夹夹闭位置不正确或未夹闭,导管脱出,且留置针存在的问题多于中心静脉导管,其中管道内有陈旧回血、输液接头内有回血发生率,外周留置针和中心导管比较差异有统计学意义(P<0.05)。结论住院患儿静脉输液率较高,虽然静脉输液工具种类繁多,但对于儿童患者输液工具的选择以外周静脉留置针穿刺和肝素帽连接为主,导管维护方面尚存在不足。Objective To investigate the use of different tools of intravenous infusion and the issues associated with intravenous catheter indwelling in hospitalized children and to provide reference for clinical practices.Methods Using the convenient sampling method,from July 24th to 31st,2018,the intravenous infusion treatment of children inpatients in 49 hospitals within the Beijing Children's Hospital Medical Association was selected for investigation.A self-designed Cross-sectional Questionnaire for Children's Intravenous Infusion and a photo of an intravenous infusion tool were used for data collection.Statistical analysis was performed using SPSS 17.0 software.Results During the data collection period,there were 18316 hospitalized children in the 49 hospitals,among which there were 14421 cases of infusions,with the infusions rate of 78.73%.The application rate of indwelling needle was 87.94%.The connector of venous catheter was mainly heparin cap connection(64.23%).The infusion tools used in 6398 cases(44.37%)were made by PVC and containing 2-ethyl hexyl phthalate(DEHP).Aseptic transparent dressing was the main dressing choice.During catheter indwelling,there were some problems such as back-blood in the pipeline or infusion joint,incorrect clamping position of small clips,unclamping,and tube detachment.Indwelling needles had more problems than central venous catheters,including old blood returning in the tube and blood returning in the infusion connector.The difference between the peripheral indwelling needle and the central catheter was statistically significant(P<0.05).Conclusions The rate of intravenous infusion in hospitalized children is relatively high.Although there are various types of intravenous infusion tools,the choice of infusion tools for children was mainly indwelling needle and heparin cap connection,and there were still room for improvement in catheter maintenance.

关 键 词：儿童 输液 工具 留置 调查研究 

分 类 号：R473[医药卫生—护理学]