藻酸盐与医用组织胶在肝硬化合并上消化道大出血患者PICC穿刺止血处理中的应用效果  

Efficacy of alginate versus medical tissue glue in the hemostatic treatment of peripherally inserted central catheter puncture on liver cirrhosis with upper gastrointestinal bleeding

作　　者：高晓佩 张鲁 仲光威娜 薛慧 米丽强 程玉霞 GAO Xiaopei;ZHANG Lu;ZHONG Guangweina(Department of Gastroenterology,PLA Strategic Support Force Characteristic Medical Center,Beijing 100101,China;不详)

机构地区：[1]中国人民解放军战略支援部队特色医学中心消化内科,北京市100101 [2]中国人民解放军战略支援部队特色医学中心护理部,北京市100101

出　　处：《河北医药》2024年第16期2498-2501,共4页Hebei Medical Journal

摘　　要：目的比较藻酸盐与医用组织胶在肝硬化合并上消化道大出血经外周植入中心静脉导管(PICC)穿刺止血处理中的应用效果。方法选取2022年3月至2023年5月消化内科住院治疗的肝硬化合并上消化道大出血患者68例,根据入院先后随机分为对照组和研究组,每组34例。对照组在穿刺点应用藻酸盐敷料,观察组在穿刺点涂抹医用组织胶治疗,观察2组穿刺点渗血情况、换药次数及导管位移情况、局部感染情况,评估患者满意度。结果置管后,研究组渗血发生率为5.88%(2/34)明显低于对照组的91.18%(31/34),差异有统计学意义(P<0.05);置管后3 d内,研究组换药次数明显少于对照组,差异有统计学意义(t=6.351,P=0.017);研究组置管后24 h内、24~72 h内换药次数均较对照组明显减少,差异有统计学意义(P<0.05);研究组置管后导管移位率2.94%(1/34)、局部感染率5.88%(2/34),低于对照组的11.76%(4/34)、23.53%(8/34)(P<0.05);研究组满意度为97.06%(33/34)高于对照组的82.35%(28/34),差异有统计学意义(P<0.05)。结论相较于藻酸盐敷料,医用组织胶能更有效预防肝硬化合并上消化道大出血PICC穿刺点渗血,减少置管后换药次数,并能避免导管移位,降低局部感染风险,提升患者满意度,值得临床推广。Objective To observe of efficacy of alginate versus medical tissue glue in the hemostatic treatment of peripherally inserted central catheter(PICC)puncture on liver cirrhosis with upper gastrointestinal bleeding.Methods Sixty-eight patients with liver cirrhosis with upper gastrointestinal bleeding who were hospitalized in the Department of Gastroenterology of our hospital from March 2022 to May 2023 were selected and divided into a control group(n=34,alginate dressing at the PICC puncture point)and a study group(n=34,medical tissue glue at the PICC puncture point).The blood leakage,dressing changes,catheter displacement,local infection,and satisfaction rate were evaluated in the both groups.Results After catheterization,the incidence of blood leakage in the study group was significantly lower than that of the control group(5.88%[2/34]vs 91.18%[31/34],P<0.05).The number of dressing changes within 3 days after catheterization in the study group was significantly less than that in the control group(t=6.351,P=0.017).The number of dressing changes within 24 hours and 24-72 hours after catheterization was significantly reduced compared to the control group(P<0.05).After catheterization,the catheter displacement rate(2.94%[1/34]vs 11.76%[4/34])and local infection rate(5.88%[2/34]vs 23.53%[8/34])in the study group were significantly lower than those of the control group(P<0.05).The satisfaction rate of the research group was significantly higher that of the control group(97.06%[33/34]vs 82.35%[28/34],P<0.05).Conclusion Compared to alginate dressings,medical tissue glue can more effectively prevent hemostatic AT PICC puncture point in liver cirrhosis and upper gastrointestinal bleeding,reduce the number of dressing changes after catheterization,avoid catheter displacement,reduce the risk of local infection,and improve patient satisfaction.It is worthy of clinical promotion.

关 键 词：藻酸盐敷料 医用组织胶 肝硬化 上消化道大出血 经外周植入中心静脉导管 止血 

分 类 号：R657.31[医药卫生—外科学]