三向瓣膜式PICC置管术中导管置入异位的观察与护理

Observation and nursing care of patients with catheter placement dystopia during accepting tri-direction valve type of peripherally inserted central catheter

[目的]探索三向瓣膜式PICC置管术中导管置入异位的症状及护理。[方法]应用观察记录法,观察记录三向瓣膜式PICC置管术中情况,包括送管阻力,撤出导丝后导管尾端溢血或溢液现象,术后X线片检查确认的导管位置等。[结果]头静脉置管的导管异位率最高,为13.4%;送管遇阻力导管置入异位率54.5%;撤出导丝后导管尾端溢血或溢液时均发生导管置入异位。[结论]部分PICC置入异位可通过观察临床症状识别,护士在PICC置管术中及时判断导管置入异位并进行调整、处理非常重要。

Objective：To explore symptoms and nursing of dystopia of catheter placement of patients accepting tri-direction valve type of peripherally inserted central catheter. Methods： By adopting observation recording method, the intraoperative state of patients accepting tri-direction valve type of peripherally inserted central catheter were observed and recorded including resistance of inserting catheter, suffusion in catheter end as withdrawing the guide wire, and the position of catheter postoperative confirmation by X-ray check and so on. Results： The rate of dystopia of inserting catheter from cephalic vein was the highest that was 13.4%. The rate of dystopia as facing resistance of catheter was 54.5%. Patients were with suffusion in catheter end as withdrawing the guide wire, the rate of dystopia of them was 100%. Conclusions： Some dystopia of patients accepting peripherally inserted central catheter can identified through observing clinical symptoms of them. It is very important for nurses to judge the dystopia and to adjust and to handle in time.