开窗式中心静脉导管组合敷贴的设计与应用  

Design and application of a combination dressing for open-window central venous catheters

作　　者：周婷 蒋蕾 华琳 邱媛 何银莹 周友全 郭语瑄 番椿蕊 吴嫦雯 Zhou Ting;Jiang Lei;Hua Lin;Qiu Yuan;He Yinying;Zhou Youquan;Guo Yuxuan;Fan Chunrui;Wu Changwen(Cancer Biotherapy Center,Cancer Research Institute,Yunnan Cancer Hospital,the Third Affiliated Hospital of Kunming Medical University,Kunming 650100,China;Medical Laboratory Department,Yunnan Cancer Hospital,the Third Affiliated Hospital of Kunming Medical University,Kunming 650100,China)

机构地区：[1]云南省肿瘤医院,昆明医科大学第三附属医院肿瘤生物治疗中心,昆明650100 [2]云南省肿瘤医院,昆明医科大学第三附属医院医学检验科,昆明650100

出　　处：《中国实用护理杂志》2025年第8期601-607,共7页Chinese Journal of Practical Nursing

基　　金：教学联盟本科教育教学研究课题(JXYJ20230205)。

摘　　要：目的探讨实用新型专利开窗式中心静脉导管组合敷贴(专利号:ZL 202121652858.8)的安全性、经济效益及临床应用效果。方法2022年10月至2023年10月采用随机对照试验,目的抽样法将符合纳入、排除标准的云南省肿瘤医院120例应留置中心静脉导管的肿瘤患者依照随机数字表按1:1:1比例分为对照组_(1)、对照组_(2)和试验组各40例。对照组_(1)使用施乐辉Ⅳ3000敷贴,对照组_(2)使用3M透明敷贴,试验组使用研究者自行研制的开窗式中心静脉导管组合敷贴进行中心静脉导管的维护。比较3组的皮肤表面细菌定植情况、医用黏胶相关性皮肤损伤发生情况、导管维护时长及维护成本。结果对照组_(1)男21例,女19例,年龄(51.53±12.01)岁。对照组_(2)男22例,女18例,年龄(54.00±11.03)岁。试验组男19例,女21例,年龄(53.60±9.41)岁。72h的观察期内,对照组_(1)、对照组_(2)和试验组分别有1、3、2例发生细菌定植,3组比较差异无统计学意义(χ^(2)=1.10,P=0.577)。试验组无医用黏胶相关性皮肤损伤发生,与对照组_(2)的4例比较差异有统计学意义(χ^(2)=4.21,P=0.040)。导管平均维护时长和维护成本,试验组分别为(15.20±1.56)min和(8.11±1.35)元,与对照组_(1)的(21.05±3.31)min和(13.16±1.03)元比较差异均有统计学意义(t=5.85、5.05,均P<0.001);与对照组_(2)的(21.08±3.00)min和(15.17±1.63)元比较差异均有统计学意义(t=5.88、7.06,均P<0.001)。结论开窗式中心静脉导管组合敷贴可有效降低医用黏胶相关皮肤损伤的发生率,在节约维护时间、降低维护成本上具有较好作用,尤其适用于穿刺点需要反复换药治疗的患者,具有方便、经济、快捷、固定牢固、安全的优势。Objective To explore the safety,economic benefits,and clinical application effect of the new practical patent open window central venous catheter combination dressing(Patent No.ZL 202121652858.8).Methods From October 2022 to October 2023,a randomized controlled trial was conducted.A total of 120 tumor patients in Yunnan Cancer Hospital with indwelling central venous catheters who met the inclusion and exclusion criteria were randomly divided into three groups at a ratio of 1:1:1 with random digit table,with 40 patients in each group:control group 1,control group 2,and the experimental group.In control group 1,Smith&NephewⅣ3000 dressing was used,in control group 2,3M transparent dressing was used;and in the experimental group,the self-developed fenestrated central venous catheter combined dressing by the researchers was used for catheter maintenance.The skin surface bacterial colonization,the occurrence of medical adhesive-related skin injuries,catheter maintenance time,and maintenance costs were compared among the three groups.Results In control group 1,there were 21 males and 19 females,with an average age of(51.53±12.01)years.In control group 2,there were 22 males and 18 females,with an average age of(54.00±11.03)years.In the experimental group,there were 19 males and 21 females,with an average age of(53.60±9.41)years.During the 72-hour observation period,1,3,and 2 cases of bacterial colonization occurred in control group 1,control group 2,and the experimental group respectively,and there was no significant difference among the three groups(χ^(2)=1.10,P=0.577).No medical adhesive-related skin injury occurred in the experimental group,and there was a significant difference compared with the 4 cases in control group 2(χ^(2)=4.21,P=0.040).The average catheter maintenance time and maintenance cost in the experimental group were(15.20±1.56)minutes and(8.11±1.35)yuan respectively.Compared with(21.05±3.31)minutes and(13.16±1.03)yuan in control group 1,the differences were statistically significant(t=5.85,5.

关 键 词：中心静脉导管 透明敷贴 导导管维护 

分 类 号：R47[医药卫生—护理学]