结核性胸腔积液胸腔置管存在的护理问题及风险管理

Nursing problems existing in tuberculous pleural effusion catheterizing and risk management

目的探讨胸腔内留置中心静脉导管治疗结核性胸腔积液患者在置管过程中存在的护理问题,进一步完善相关护理干预流程,降低护理风险。方法回顾性分析64例采用单腔中心静脉导管留置胸腔进行引流治疗结核性胸腔积液患者的临床资料,并总结护理要点。结果 62例患者均一次置管成功,1例患者术前准备不到位致置管失败,发生导管相关性感染5例,导管脱出5例,胸水标本留取不符合消毒隔离要求4例。结论置管前的充分准备及心理护理、置管中严格无菌操作、密切观察病情、置管后引流管期间加强管道的维护,是确保胸腔内置管引流术治疗成功以及提高护理质量的关键。

Objective The nursing problem in the process of Intrathoracic indwelling central venous catheter in the treatment of patients with tuberculous pleural effusion was investigated in order to further improve the nursing Inter- vention process and reduce nursing risks. Methods The clinical data of 64 patients with pleural eatheterizing single- lumen central venous catheters in the drainage treatment of tuberculous pleural effusion was retrospectively analyzed and summarized the nursing points. Results A total of 62 patients successful catheterized. 1 patient failed in placing the catheter due to inadequate preoperative preparation. Catheter-related infection and catheter prolapsus occurred in 5 cases, respectively. And 4 pleural effusion specimens did not meet the requirements of disinfection and isolation. Conclusion Adequate preparation and psychological care before catheterization, strict aseptic operating and close ob- servation during the catheterization and enhancing the catheter maintenance during drainage are the keys to ensure the success of the intrathoracic indwelling central venous catheter drainage surgery and improving the quality of nursing.