精细化护理在乳腺癌PICC置管化疗患者中的应用对导管相关性上肢深静脉血栓预防效果的价值探讨  

Value of Application of Refined Nursing in Breast Cancer Patients with PICC Catheterization Chemotherapy for the Prevention of Atheter Re⁃lated Deep Venous Thrombosis of Upper Extremity

作　　者：林秀银[1] 罗春霞[1] 苏连珠[1] 姜玉清[1] LIN Xiuyin;LUO Chunxia;SU Lianzhu;JIANG Yuqing(Department of General Surgery,Sanming Second Hospital,Sanming,Fujian Province,366000 China)

机构地区：[1]福建省三明市第二医院普外科,福建三明366000

出　　处：《中外医疗》2024年第9期124-128,共5页China & Foreign Medical Treatment

摘　　要：目的探讨精细化护理在乳腺癌经外周静脉置中心静脉导管(Peripherally Inserted Central Venous Catheter,PICC)置管化疗患者中的应用及对导管相关性上肢深静脉血栓(Catheter Related Deep Venous Thrombosis of Upper Extremity,UEDVT)的预防效果。方法单纯随机选取2021年10月—2023年7月福建省三明市第二医院行PICC置管化疗的90例乳腺癌患者为研究对象,以随机数表法为依据分为两组,对照组(45例)实施常规护理,观察组(45例)基于对照组实施精细化护理,比较两组的UEDVT及其他置管事件发生情况、干预前后的腋下血液流速、血栓弹力图(Thromboelastography,TEG)参数以及生活质量。结果观察组UEDVT及其他置管事件的发生率(2.22%和4.44%)均低于对照组(17.78%和17.78%),差异有统计学意义(χ^(2)=4.444、4.050,P均<0.05)。干预后,观察组两项腋下血液流速指标(最大血液流速与静脉平均血液流速)均快于对照组,差异有统计学意义(P均<0.05)。干预后,观察组TEG参数中的R值高于对照组,MA值低于对照组,差异有统计学意义(P均<0.05)。干预后,观察组生活质量评分量表中的环境、社会、生理及心理得分均高于对照组,差异有统计学意义(P均<0.05)。结论精细化护理能够有效改善乳腺癌PICC置管化疗患者的腋下血液流速,预防UEDVT及其他置管事件发生,提升患者置管期间的生活质量。Objective To study the application of refined nursing in breast cancer patients with peripherally inserted central venous catheter(PICC)catheterization chemotherapy and its preventive effect on atheter related deep venous thrombosis of upper extremity(UEDVT).Methods A total of 90 breast cancer patients admitted to Sanming Second Hospital from October 2021 to July 2023 for PICC catheterization chemotherapy were simple randomly selected as the study objects and were divided into two groups according to random number table method.Control group(45 cases)re⁃ceived routine nursing,observation group(45 cases)based on the control group received refined nursing.UEDVT and other catheterization events,axillary blood flow,thromboelastography(TEG)parameters and quality of life before and after intervention were compared between the two groups.Results The incidence rate of UEDVT and other catheteriza⁃tion events in observation group(2.22%and 4.44%)were lower than those in control group(17.78%and 17.78%),and the differences were statistically significant(χ^(2)=4.444,4.050,both P<0.05).After intervention,the two indexes of axil⁃lary blood flow velocity(maximum blood flow velocity and average venous blood flow velocity)in the observation group were faster than those in the control group,and the differences were statistically significant(both P<0.05).After inter⁃vention,the R value of TEG parameter in observation group was higher than that in control group,and the MA value was lower than that in control group,and the differences were statistically significant(both P<0.05).After the inter⁃vention,the environmental,social,physiological and psychological scores of the quality of life rating scale in the ob⁃servation group were higher than those in the control group,and the differences were statistically significant(all P<0.05).Conclusion Refined nursing can effectively improve the axillary blood flow rate of breast cancer patients with PICC catheterization chemotherapy,prevent UEDVT and other catheterization events,and i

关 键 词：乳腺癌 PICC置管化疗 精细化护理 上肢深静脉血栓 

分 类 号：R5[医药卫生—内科学]