老年患者经外周置入中心静脉导管并发症原因分析及护理对策

Complication and nursing care of peripherally inserted central catheter （PICC） in gerontal patients

目的对164例老年患者经肘正中静脉穿刺置管（PICC）的并发症及相关因素进行分析，提供有效的护理对策以减少并发症的发生，延长导管的留置时间。方法对2005年6月至2009年6月我科住院老年患者164例，进行回顾性分析。结果164例中，16例因死亡，留置时间为7—180d，另外148例留置时间为14—366d。置管后并发症：穿刺点渗血6例（3．66％），早期机械性静脉炎5例（3．05％），导管阻塞5例（3．05％），导管部分脱出4例（2．43％），导管破裂7例（4．27％），导管相关感染3例（1．83％）。结论加强PICC的规范化护理操作培训，做好患者及家属的宣传教育工作，可以减少或者避免并发症的发生。

Objective To analyzes the incidence and risk factors of PICC-related complications in gerontal patient, and provide effective nursing care strategy. Methods 164 cases of gerontal male patients who need long-term administration of antibiotics, chemotherapy, and parenteral nutrition accepted the PICC therapy. Results The median PICC dwell time was 123 days （ 14 - 366 days）. The complication rate of pricking errhysis was 3.66% （6/164）, early phlebitis was 3.05% （5/164）, catheter blockage was 3.05% （5/164）, catheter exodus partly was 2.43% （4/164）, catheter rupture or breakage was 4.27% （7/164）, catheter- related infection was I. 83% （3/164）. Conclusions Enhancing the normalized nursing procedure of PICC and instruction the patients and their family how to deal with the catheter will decrease or avoid the PICC-related complications.