采血固定器在呼吸科重症监护病房动脉采血中的应用效果

Effects of blood collection fixture in arterial blood collection in Respiratory Intensive Care Unit

目的分析采血固定器在呼吸科重症监护病房(RICU)动脉采血中的应用效果,为优化临床护理工作提供研究依据。方法采用便利抽样法,选取2018年1—12月在RICU住院治疗的496例患者作为研究对象,根据入院登记号的单双号将其分为研究组和对照组,每组各248例。对照组患者采用传统的垫腕枕定位、棉签按压止血方式进行桡动脉穿刺采血,研究组患者采用自制采血固定器进行采血。观察和比较两组患者的穿刺用时、采血操作用时、一针穿刺成功率;对两组患者住RICU期间动脉采血部位的血液外渗、穿刺局部瘀斑、皮肤牵拉疼痛等穿刺不良事件的发生率进行观察和对比。结果两组患者共采血2110次,研究组患者和对照组患者分别采血1079次和1031次;研究组患者的穿刺用时、采血操作用时分别为(2.46±0.38)min和(5.53±0.98)min,均短于对照组的(4.02±0.43)、(6.06±1.35)min,差异有统计学意义(P<0.01)。研究组患者的一次穿刺成功率为95.74%(1033/1079),高于对照组的82.93%(855/1031),差异有统计学意义(P<0.01)。研究组患者的血液外渗、穿刺局部瘀斑、皮肤牵拉疼痛发生率分别为2.50%(27/1079)、4.45%(48/1079)、7.32%(79/1079),均低于对照组的17.26%(178/1031)、16.10%(166/1031)、28.81%(297/1031),差异有统计学意义(P<0.01)。结论在RICU桡动脉采血操作中应用采血固定器能够提高穿刺成功率,缩短穿刺时间,节约采血操作时间,并可减少穿刺不良事件的发生。

Objective To analyze the effects of blood collection fixture in arterial blood collection in the Respiratory Intensive Care Unit(RICU)and provide a basis for optimizing clinical nursing work.Methods Totally 496 patients hospitalized in RICU between January and December 2018 were selected by convenient sampling and divided into the study group(n=248)and the control group(n=248)on the basis that their admission registration number is even or odd.Patients in the control group used traditional wrist cushion positioning and cotton swab presses to stop bleeding in performing radial puncture blood collection,while patients in the study group used home-made blood collection fixtures for blood collection.Puncture time,operation time of blood collection and the success rate of one-needle puncture were observed and compared between the two groups.The incidence rate of adverse puncture events such as blood extravasation,local ecchymosis at puncture sites and skin traction pain during the collection of arterial blood in RICU were observed and compared between the two groups.Results Totally 2110 blood samples were taken from the two groups,including 1079 for the study group and 1031 for the control group respectively.The puncture time and blood collection time in the study group were(2.46±0.38)min and(5.53±0.98)min respectively,both shorter than(4.02±0.43)min and(6.06±1.35)min in the control group,and the differences were statistically significant(P<0.01).The success rate of one-needle puncture in the study group was 95.74%(1033/1079),which was higher than 82.93%(855/1079)in the control group,and the difference was statistically significant(P<0.01).The incidences of blood extravasation,local ecchymosis at puncture sites and skin traction pain in the study group were 2.50%(27/1079),4.45%(48/1079),and 7.32%(79/1079),which were lower than 17.26%(178/1031),16.10%(166/1031),and 28.81%(297/1031)in the control group,and the differences were statistically significant(P<0.01).Conclusions The use of blood collection fixtures in radial artery blood collection operation in RICU can improve the success rate of puncture,shorten the puncture time,save the time of blood collection operation,and reduce the incidence of adverse puncture events.