水凝胶敷贴联合绷带固定预防静脉留置针静脉炎的效果

Effect of hydrogel bandage applicator together with wound care bandage in the prevention of indwelling intravenous catheter phlebitis

目的探讨通过临床护理措施预防静脉留置针静脉炎的方法。方法将2010年1—10月妇科住院手术后，采用静脉留置针方式进行常规输液的女性患者300例，随机分为三组，每组100例。实验1组采用冷敷硫酸镁纱布＋伤口护理绷带固定；实验2组采用水凝胶敷贴＋伤口护理绷带固定；对照组采用伤口护理绷带固定。观察各组静脉留置针留置时间以及静脉炎出现情况。结果三组患者静脉留置针留置时间为3d的比率分别为86％，97％和71％，实验1组和实验2组与对照组比较，差异有统计学意义（Hc=6．80，26．15；P〈0．05或P〈0．01）；实验1组和实验2组比较，差异亦有统计学意义（Hc：7．80，P〈0．05）。三组患者发生静脉炎的比率分别为23％、6％和44％．实验1组和实验2组与对照组比较，差异有统计学意义（Hc=9．94，38．64；P〈0．05或P〈0．01）；实验1组和实验2组比较，差异亦有统计学意义（Hc=11．81，P〈0．01）。防止静脉炎发生的有效率分别为90％，97％和78％。结论使用硫酸镁或水凝胶敷贴可以延长留置针使用时间，有效预防留置针静脉炎发生，而使用水凝胶敷贴联合绷带固定预防静脉炎的效果更好。

Objective To investigate the prevention of indwelling intravenous catheter phlebitis through nursing care. Methods 300 cases of postoperative patients admitted to the gynecology department, from January 2010 to October 2010, were randomly assigned into 3 groups. The punctured regions were treated by cold magnesium sulfate gauze together with wound care bandage （ experimental group 1 ）, hydrogel bandage applicator together with wound care bandage （experimental group 2 ）, and wound care bandage （control group）, respectively. The intravenous catheter retention time and incidence of phlebitis were observed. Results The 3-day retention rate of indwelling intravenous catheter of the three groups was 86%, 97%, 71%, respectively. There were significant differences between experimental group 1, experimental group 2 and the control group （ Hc = 6.80,26.15 ; P 〈 0. 05 or P 〈 0. 01 ）. There was also significant difference between experimental group land experimental group 2 （ Hc = 7. 80, P 〈 0. 05 ）. The incidence of phlebitis was 23%, 6%, 44%, respectively. There were significant differences between experimental group 1, experimental group 2 and the control group （ Hc = 9.94,38.64; P 〈 0. 05 or P 〈 0. 01 ）. There was also significant difference between experimental group land experimental group 2 （ Hc = 11. 81, P 〈 0. 01 ）. The effective rate of phlebitis prevention was 90%, 97%, 78%, respectively. Conclusions The use of magnesium sulfate or hydrogel bandage can effectively extend the indwelling intravenous catheter retention time and prevent catheter phlebitis, and the latter may be superior in preventing phlebitis.