水胶体敷料预防PICC置管术后机械性静脉炎的效果

Effects of Hydrocolloid Dressing in Preventing Mechanical Phlebitis of Peripherally Inserted Central Catheter

目的探讨水胶体敷料预防经外周静脉中心静脉置管（peripherally inserted central catheter,PICC）致机械性静脉炎的效果。方法将2007年4月至2009年11月接受PICC置管术的30例患者根据置管时间分为两组：A组采用常规的湿热敷;B组用9cm×14cm的水胶体敷料（康惠尔透明贴）沿穿刺静脉走向平行覆盖于穿刺点上方3～5cm,持续覆盖5d,有松脱情况及时更换。观察两组患者5d内机械性静脉炎的发生情况、舒适度及护士的操作时间。结果 A、B两组患者机械性静脉炎的发生率分别为25.00%和5.56%,且A组患者静脉炎的严重程度重于B组,差异有统计学意义（P〈0.05）;B组患者在皮肤刺激、限制活动和暴露肢体等方面的不适均轻于A组（P〈0.05）;A组护士执行干预措施的平均用时为（37±10）min,B组为（2±1）min,差异有统计学意义（t=12.084,P〈0.05）。结论水胶体敷料能有效降低机PICC置管致械性静脉炎的发生率,有助于提高患者的舒适度,减轻护理工作量。

Objective To investigate the effects of hydrocolloid dressing in preventing mechanical phlebitis after peripherally inserted central catheters（PICC）.Methods Thirty patients who underwent PICC from April 2007to November 2009were randomly divided into two groups：group A using conventional hot and humid deposition and group B using hydrocolloid dressing（Comfeel transparent paste,9cm×14cm）,which was covered 3-5cm above the puncture point along the ways of venous puncture for 5days,and it was replaced when it was loose.The incidence of mechanical phlebitis,the patients＇comfortable feeling level and the implementation time of nurse of each group in 5days were observed.Results The incidences of phlebitis in group A and group B were 25.00%and 5.56%,respectively.The severity of phlebitis in group A was significantly superior to that in group B（P0.05）.The discomforts in skin irritation,restriction on activities and physical exposure in group B were significantly lighter than those in group A（P0.05）.The average time for implementing intervention measure in group A and group B was（37±10）min and（2±1）min respectively with significant differences on inspection（t=12.084,P0.05）.Conclusion Hydrocolloid dressing can reduce the incidence of mechanical phlebitise,improve patients＇comfort and reduce the nursing workload.