心电导联中心静脉置管技术在肿瘤患者中的应用体会

Application of Electrocardiogram in Central Venous Catheterization for Patients with Tumors

总结326例肿瘤患者在中心静脉置管过程中应用心电导联技术的护理经验。通过穿刺过程中加强护患沟通,利用心电图P波改变及时调整导管尖端位置,改变穿刺方法,提高了穿刺成功率,减少了X线的放射性污染及穿刺点的局部出血。本组326例患者均成功置管,1次置管成功率相比传统中心静脉置管提高了约4%。本组6例患者在未见P波改变情况下,改用X线定位;78例患者穿刺处少量渗血持续2～3 d,经积极处理后,出血停止。所有病例均顺利完成化疗。

This paper introduced the application of electrocardiogram in central venous catheterization for 326 patients with tumors and its nursing care. With the change of P wave of electrocardiography, the central venous catheter tip could be inspected, which contributed to the improvement of success rate and there was less radioactive pollution from X-ray and less local hemorrhage in puncture point. All catheters were successfully placed and the success rate was improved. Since no change of P wave was detected, the central venous catheter was placed with X-ray positioning among six patients. Oozing lasted in puncture point among 78 patients for 2 to 3 days and stopped after treatment. The communication between patients and nurses played a critical part in the whole process. Successful completion of chemotherapy was witnessed in all patients in the study.