肿瘤姑息治疗患者PICC置管部位MARSI的危险因素分析  

Risk factors for medical adhesive-related skin injury at peripherally inserted central catheters catheterization site in patients with tumor palliative care

作　　者：周劼[1] 黄彩献 Zhou Jie;Huang Caixian(Nursing Department,the People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院护理部,南宁530021

出　　处：《中华现代护理杂志》2023年第14期1917-1920,共4页Chinese Journal of Modern Nursing

摘　　要：目的分析肿瘤姑息治疗患者经外周静脉置入中心静脉导管(PICC)置管部位医用粘胶剂相关性皮肤损伤(MARSI)的危险因素。方法采用便利抽样法,选取2019年6月—2020年6月广西壮族自治区人民医院进行肿瘤姑息治疗的患者315例为研究对象,根据其是否发生MARSI将其分为发生组、未发生组。比较两组的一般资料和临床资料差异;采用Logistic回归分析法分析患者MARSI的危险因素。结果315例肿瘤姑息治疗患者中,PICC置管部位发生MARSI的有100例(31.75%)。与未发生组比较,发生组PICC穿刺部位为肱二头肌内侧、PICC置管次数≥2次、大角度移除敷贴、敷料种类为半透膜、敷料更换频率为2次/周、PICC导管维护延迟的比例升高,差异有统计学意义(P<0.05);Logistic回归分析显示,PICC穿刺部位为肱二头肌内侧、PICC置管次数≥2次、大角度移除敷贴、敷料种类为半透膜、敷料更换频率为2次/周、PICC导管维护延迟均为肿瘤姑息治疗患者PICC置管部位发生MARSI的危险因素(P<0.05)。结论肿瘤姑息治疗患者PICC置管部位发生MARSI的危险因素众多,临床需采取针对性预防措施,以减少MARSI。Objective To analyze risk factors of medical adhesive-related skin injury(MARSI)at the site of peripherally inserted central catheters(PICC)in patients with tumor palliative care.Methods A total of 315 patients who underwent tumor palliative care in the People's Hospital of Guangxi Zhuang Autonomous Region from June 2019 to June 2020 were selected as the research objects by the convenient sampling method,and they were divided into the occurrence group and the non-occurrence group according to whether they had MARSI.The differences of general and clinical data between the two groups were compared.Logistic regression analysis was used to analyze the risk factors of MARSI.Results Among 315 tumor palliative care patients,100 cases(31.75%)had MARSI at PICC catheterization site.Compared with the non-occurrence group,the occurrence group showed an increase in the proportion of PICC puncture site on the medial side of the biceps brachii,PICC catheterization frequency greater than or equal to 2 times,large angle removal of the dressing,semi permeable dressing type,dressing replacement frequency of 2 times per week and delayed maintenance of PICC catheters,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that PICC puncture site on the medial side of the biceps brachii,PICC catheterization frequency greater than or equal to 2 times,large angle removal of the dressing,semi permeable dressing type,dressing replacement frequency of 2 times per week and delayed maintenance of PICC catheters were all risk factors for MARSI at the PICC catheterization site in tumor palliative treatment patients(P<0.05).Conclusions There are many risk factors for MARSI at the PICC catheter site in patients undergoing tumor palliative care and targeted preventive measures need to be taken in clinical practice to reduce MARSI.

关 键 词：肿瘤 姑息治疗 经外周静脉置入中心静脉导管 医用粘胶剂相关性皮肤损伤 

分 类 号：R473.73[医药卫生—护理学]