1例锁骨下静脉置管行血液透析3年的护理体会

A Case on the Nursig for Patients with Hemodialysis by Intravenous Catheter under Collarbone for 3 Years

目的通过加强对长期锁骨下静脉置管患者的护理,防止与导管相关的感染与血栓形成,从而有效延长导管使用时间,保证患者充分透析。方法按无菌操作规程操作,用肝素盐水封管,透析时适当控制血流量,做好健康教育。结果锁骨下静脉置管3年中未发生与导管相关的感染、导管堵塞及血流不畅,血流量可达220 ml/min以上,透析有效。结论良好的护理能够有效防止长期锁骨下静脉相关的感染和导管堵塞,保证有效透析,提高患者生活质量。

Objective To prevent the related infection and thrombus by strengthening the nursing for patients with intravenous catheter under collarbone in a long period so as to prolong the period of use for catheter effectively and make the patients get a sufficient dialysis. Methods According to sterile technique to seal the catheter with heparinate, control the volume of bleeding properly while dialysis and give the health education. Results Intravenous catheter under collarbone last for 3 years, in which there were not symptoms such as the related infection, catheter jamming and unsmooth bleeding, the volume of bleeding is over 220 ml/min, so the patients may get an effective dialysis. Conclusion Better nursing may effectively prevent related infection and catheter jamming with intravenous catheter under collarbone in a long period so as to have an effective dialysis and improve the patient＇s quality of life.