藻酸盐敷料用于PICC置管术后穿刺点止血的效果观察

Clinical observation of alginate dressing in hemostasis after peripherally inserted central catheter

目的观察藻酸盐敷料用于经外周植入中心静脉导管(PICC)置管术后穿刺点止血的效果。方法将120例行PICC置管术的肿瘤患者随机分为试验组(n=60)和对照组(n=60)。PICC置管成功后,对照组采用传统的透明敷料加纱球固定;试验组用藻酸盐敷料对折两次覆盖于穿刺点上方,并用一纱球压迫后覆盖透明敷料。观察并比较两组患者PICC穿刺成功后穿刺点24h内的出血情况。结果试验组中穿刺点24h内无渗血44例(73.3%),轻度渗血8例(13.3%),中度渗血6例(10.0%),重度渗血2例(3.3%);对照组中无渗血5例(8.3%),轻度渗血25例(41.6%),中度渗血20例(33.3%),重度渗血10例(16.7%),两组差异有统计学意义(P<0.05)。试验组24h内平均换药1.1次,对照组为2.2次,差异具有统计学意义(P<0.05)。结论藻酸盐敷料用于PICC置管术后穿刺点止血效果好,可以明显减少换药次数。

Objective To observe the effect of alginate dressing on hemostasis after peripherally inserted central catheter （PICC）. Methods A total of 120 patients undergoing PICC cathetering were randomly divided into trial group（n =60） and control group （n = 60）. All 120 patients were treated with a tampon oppressed on the spot of puncture and covered with a transparent dressing, while 60 patients in the trial group were covered with a two-folded alginate dressing additionally. The bleeding conditions were com- pared between the two groups in 24 hours after PICC cathetering. Results Bleeding was observed in 16 patients in the trial group （ 16. 7% ） ; and the frequency of bleeding degree of mild, moderate and severe were 13.3%, 10. 0% and 3.3% respectively. In the control group, bleeding was observed in 55 patients, and frequency of bleeding degree of mild, moderate and severe were 41.6% , 33.3% and 16. 7% respectively. The average times of dressing changing in trail group and control group were 1.1 and 2. 2. There were significant differences between two groups （P 〈 0. 05）. Conclusion Alginate soft-fills has a definite hemostasis effect after PICC cathetering, so as to reduce dressing changing times.