循证护理预防晚期胃癌患者PICC术后并发症的效果

Effects of Evidence-based Nursing in Preventing Complications of Peripherally Inserted Central Catheters in Patients with Advanced Gastric Cancer

目的探讨循证护理在预防晚期胃癌患者发生经外周静脉植入中心静脉导管(peripherally inserted central catheters,PICC)术后并发症的效果。方法选择2009年1月至2010年3月,在福州总医院肿瘤科住院首次PICC的晚期胃癌患者62例,采用随机数字表法将其分为观察组(N=38)和对照组(N=24),观察组患者按照循证护理方案进行护理,对照组患者按照常规护理方案进行护理,观察两组患者首次穿刺成功率及PICC置管后第1、2个月时并发症的发生情况。结果两组患者在首次穿刺成功率上的差异无统计学意义(P>0.05)。PICC术后1个月内,两组患者均未出现导管脱落情况,且两组患者在发生静脉炎、皮肤过敏及感染上的差异均无统计学意义(均P>0.05)。术后第2个月,两组患者在发生静脉炎、皮肤过敏、感染上的差异均有统计学意义(均P<0.05)。结论经循证后制定的方案比常规护理方案在降低PICC置管并发症的发生率更为有效,是值得推广的好方法。

Objective To investigate the effects of the improved evidence-based nursing in preventing complications after peripherally inserted central catheters（PICC） on patients with advanced gastric cancer.Methods From January 2009 to March 2010,62 patients with advanced gastric cancer who underwent PICC for the first time were divided randomly into observation group（N=38） to receive the evidence-based nursing programme and control group（N=24） to receive the routine nursing programme.Comparisons were conducted on the first-time success rate of puncture and the incidences of complications at first and second month after PICC.Results No significant difference was observed in the first-time success rate of puncture between the two groups（P0.05）.After one month of PICC,no catheter defluxion occurred in both groups and no significant different was observed in the incidents of phlebitis,skin allergy and infections between the two groups（P0.05）.At second month after PICC catheter,significant differences were observed in the incidents of phlebitis,skin allergy and infections between the two groups（P0.05）.Conclusion Compared with the routine nursing programme,the evidence-based nursing programme is more effective in decreasing the incidence of complications after PICC catheter,and thus deserves further clinical popularization.