颈内中心静脉导管拔除规范化护理方案的制订与应用  

The development and application of a standardized nursing program for removal of internal jugular central venous catheter

作　　者：杨慧[1] 刘赛赛 陈瑞云[1] 王淑粉[2] 赵文利[3] YANG Hui;LIU Saisai;CHEN Ruiyun;WANG Shufen;ZHAO Wenli

机构地区：[1]河南省人民医院胸外科,郑州市450003 [2]河南省人民医院护理部,郑州市450003 [3]河南省人民医院导管室,郑州市450003

出　　处：《中华护理教育》2022年第10期932-937,共6页Chinese Journal of Nursing Education

摘　　要：目的构建颈内中心静脉导管拔除护理方案,规范医护人员操作行为,降低患者相关问题发生率。方法通过文献检索、质量评价、提取并汇总证据及专家咨询,制订中心静脉导管拔除规范化护理方案,主要包括拔除时机、拔除前评估、拔除操作要点、拔除后注意事项及并发症处理。采用非同期对照研究,便利选取2021年5月—6月70例住院患者为对照组,采用常规颈内中心静脉导管拔除操作流程;2021年7月—8月的75例住院患者为试验组,实施颈内中心静脉导管拔除规范化护理方案;比较两组患者穿刺点疼痛、穿刺点渗血、拔管困难、导管断裂发生率。结果干预后,两组患者穿刺点疼痛、穿刺点渗血发生率比较,差异有统计学意义(χ^(2)=4.494、4.116,P<0.05);两组患者拔管困难、导管断裂发生率比较,差异无统计学意义(P>0.05)。结论开展中心静脉导管拔除规范化护理方案,可降低中心静脉导管拔除相关问题发生率,提高中心静脉导管拔除护理质量。Objective To explore the nursing plan for the removal of internal jugular central venous catheter,standardize the operation behavior of medical staff,and reduce the incidence of discomfort symptoms.Methods Through literature search,quality evaluation,extraction and summary of evidence and expert consultation,a standardized nursing plan for central venous catheter extraction was formulated,mainly including extraction time,evaluation before extraction,key points of extraction operation,precautions after extraction and treatment of complications.A non-synchronous controlled study was conducted.Seventy cases were allocated to the control group from May to June 2021 receiving routine central venous catheter extraction operation process.Another 75 cases in the experimental group from July to August 2021 carried out standardized nursing scheme for central venous catheter extraction.The incidence of pain,bleeding,difficulty in extubation and catheter rupture were compared between the two groups.Results After the intervention,there was significant difference between the two groups in the incidence of pain at the puncture point,bleeding at the puncture point(χ^(2)=4.494,4.116;P<0.05).There were no significant differences in the incidence of difficult extubation and catheter rupture between the two groups(P>0.05).Conclusion Carrying out the standardized nursing scheme of central venous catheter extraction can reduce the incidence of related questions,so as to improve the nursing quality of central venous catheter extraction.

关 键 词：护理 健康教育 中心静脉导管拔除 

分 类 号：R472[医药卫生—护理学]