新型冠状病毒肺炎疫情期间肿瘤患者治疗间歇期PICC管理策略  

Management strategy of intermittent PICC in patients with tumor during COVID-19 epidemic

作　　者：江晓林 王亚玲 单锦露 刘丁 彭娜 张蕊[4] JIANG Xiaolin;WANG Yaling;SHAN Jinlu;LIU Ding;PENG Na;ZHANG Rui(Department of Oncology,Daping Hospital,Army Medical University,Chongqing 400042,China;Department of Nursing,Daping Hospital,Army Medical University,Chongqing 400042,China;Department of Disease Prevention and Control,Daping Hospital,Army Medical University,Chongqing 400042,China;Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan 631137,China)

机构地区：[1]陆军军医大学大坪医院肿瘤科,重庆400042 [2]陆军军医大学大坪医院护理部,重庆400042 [3]陆军军医大学大坪医院疾病预防控制科,重庆400042 [4]成都中医药大学,四川成都631137

出　　处：《现代医药卫生》2020年第20期3188-3190,3193,共4页Journal of Modern Medicine & Health

摘　　要：目的加强新型冠状病毒肺炎(COVID-19)疫情期间治疗间歇期肿瘤患者经外周静脉穿刺中心静脉置管(PICC的维护管理,做好患者的居家指导,降低患者和护理人员的感染,保证疫情期间的安全。方法对COVID-19疫情期间需要进行导管维护的治疗间歇期肿瘤患者,通过信息化平台实施线上管理和居家指导,根据疫情情况预约对接维护网络医院和时间,建立管理小组、加强PICC专科护士防护和诊室感染控制、调整PICC维护流程、实施心理疏导等。结果共892例治疗间歇期携带PICC肿瘤患者,该院维护701例,对接维护网点101例,网点技术指导63例,推送防控要点165条。该院维护病例中发热患者共86例,其中感冒32例,肿瘤性发热30例,导管相关性感染12例,肺部感染10例,尿路感染2例。16例经过CT或核酸排查后解除疑似,其余患者行胸片结合病情排除。无确诊或疑似COVID-19病例发生,专科护士也无一感染新型冠状病毒。结论面对突发疫情,根据自身学科特点制定相应的应急管理方案,提高护理人员的抗疫应急能力,保证治疗间歇期携带PICC肿瘤患者的居家安全。Objective To strengthen the maintenance and management of PICC in the treatment of intermittent tumor patients during COVID-19 epidemic,do a good job of home-based guidance for patients,reduce the infection of patients and nursing staff,and ensure the safety during COVID-19 epidemic.Methods Providing online management and home-based guidance for patients with intermittent cancer who need catheter maintenance during COVID-19 epidemic,through the information platform.According to the epidemic situation,making an appointment to connect and maintain the network hospital and time,establishing a management team,strengthening the protection of PICC specialist nurses and enhancing the control of infection in the consulting room,adjusting the maintenance process of PICC,and implementing psychological counseling,etc.Results There were 892 patients,among which 701 patients were maintained in our hospital,101 patients were connected with maintenance networks,63 patients were under technical guidance of networks,165 key points of prevention and control were pushed.There were 86 cases of fever in our hospital,among which 32 cases catched a cold,30 cases belonged to tumor fever,12 cases belonged to catheter-related infection,10 cases belonged to lung infection and 2 cases belonded to urinary tract infection.Sixteen cases were removed after CT or nucleic acid screening,and the rest of patients were excluded by chest X-ray.The novel coronavirus was not infected by the specialist nurses without any confirmed or suspected COVID-19 cases.Conclusion Facing the outbreak of this epidemic,according to the characteristics of their own disciplines,we should develop the corresponding emergency management program to improve the emergency ability of nurses andto ensure the treatment of intermittent patients with PICC tumor at home safety.

关 键 词：新型冠状病毒肺炎 肿瘤 治疗间歇期 经外周静脉穿刺中心静脉置管 置管管理 

分 类 号：R73[医药卫生—肿瘤]