肿瘤患者化疗间歇期留置PICC的社区护理效果观察

Effects of Community Nursing for Tumor Patients with PICC at the Intermission of Chemotherapy

目的探讨肿瘤患者化疗间歇期留置PICC的社区护理效果及其可行性。方法将符合入选标准的78例需应用PICC作为静脉通道进行化疗的恶性肿瘤患者,按自愿原则分为两组,对照组42例患者置管后至拔管(含化疗间歇期)均在医院住院,接受常规导管护理。观察组36例患者置管后于化疗间歇期带PICC进入家庭休养,由社区护士或肿瘤科护士到家庭进行导管护理,每周1～2次。观察两组患者留置PICC期间的感染、导管阻塞、导管脱落、导管异位等并发症发生情况。结果观察组并发症发生率为19%(7/36),其中发生感染2例,导管阻塞1例,导管脱落1例,导管异位2例,机械性静脉炎1例;对照组并发症发生率为17%(7/42),其中发生导管阻塞2例,导管脱落2例,导管异位2例,机械性静脉炎1例。两组并发症发生率比较,χ2=0.10,P>0.05,差异无统计学意义。结论肿瘤化疗患者在化疗间歇期留置PICC到社区接受导管护理安全可行。

Objective To study the effect and feasibility of the nursing for tumor patients with PICC at the intermission of Chemotherapy. Methods 78 tumor patients qualified for the inclusion of the study, or those in need of indwelling PICC, were, according to their will, divided into the control group （n=42） and the observation group （n=36）. The control group were arranged to stay in the hospital after the indwelling of the PICC until the extubation and received the conventional nursing for the PICC, and the observation group were allowed to stay at home and offered home nursing for the PICC by community nurses or nurses from the oncological department, 1 to ：2 times a week. Then observations and a comparison were made of the incidence of infections, catheter blockage, shedding and dystopia, etc. Results The rate of incidence of complications among the observation group was 19% （7/36）, with two cases of infections, 1 case of catheter blockage, 1 case of catheter shedding, 2 cases of catheter dystopia, and 1 case of mechanical phlebitis; that among the control group registered 17% （7/42）, with 2 cases of catheter blockage, 2 cases of catheter shedding, 2 cases of catheter dystopia, and 1 case of mechanical phlebitis. The differences between the two groups had no statistical significance （χ^2=0.10, P〉0.05）. Conclusion Community nursing for tumor patients with PICC at the intermission of chemotherapy is safe and practicable.