两种PICC体外固定方法对患者使用体验的影响

Effect of two kinds of fixation method of PICC on patients’ experience

目的：比较PICC体外固定方法中胶条固定法和思乐扣固定技术在患者使用体验方面的优劣，以期为临床应用提供指导和借鉴。方法选取2011年6月-2012年6月在北京市某三级甲等医院门诊置入PICC的患者169例，采用随机数字表法分为胶条组86例和思乐扣组83例，分别采用胶条和思乐扣对PICC导管进行固定，比较两组患者疼痛评分、心理状态并通过欧洲五维健康量表（ EQ-5D）对患者的生活质量进行评价。结果固定1 d后胶条组和思乐扣组置管后疼痛评分分别为1和3，1周后分别为0和2，两组疼痛评分比较差异有统计学意义（χ2值分别为52．139，30．856；P＜0．01）；胶条组和思乐扣组患者对固定方式的恐惧比例分别为13％和3％，对固定效果感到担心的比例分别为61％和6％，感觉固定方式影响形象的比例分别为11％和59％，两组比较差异均有统计学意义（χ2值分别为34．867，125．699，107．756；P＜0．01）。置管后第8周观察期结束时，胶条组和思乐扣组健康指数分别为0．78和1，两组生活质量比较差异有统计学意义（χ2＝52．746，P＜0．01）。结论在固定方式的疼痛评分方面，胶条组优于思乐扣组；在患者的心理状态和生活质量方面，思乐扣组优于胶条组。

Objective To compare the two kinds of fixation method of peripherally inserted central catheters （ PICC ） including tape and statlock on patients ’ experience , in order to provide the guidance and reference for clinical application .Methods One hundred and sixty -nine patients with PICC from June 2011 to＆amp;nbsp;June 2012 in Beijing in the tertiary A hospital were chosen and divided into the tape group which received the tape fixation of the PICC （ n=86 ） and the statlock group which received the statlock fixation of the PICC （ n=83） according to the random number table .The score of pain, mental state, life quality evaluated by European quality of life 5-dimensions （EQ-5D） in patients were compared between the two groups .Results The scores of pain in the tape group and the statlock group were respectively 1 and 3 after one day , and were 0 and 2 after one week, and the differences were statistically significant （χ2 =52.139, 30.856, respectively;P＆lt;0.01）.In the tape group and the statlock group , the percent of patients who feared about the fixation method were respectively 13%and 3%, and the percent of patients who were anxious about the fixation effect were respectively 61%and 6%, and the percent of patients who thought that the fixation method might affect the personal appearance were respectively 11% and 59%, and the differences were statistically significant （χ2 =34.867, 125.699, 107.756, respectively;P＆lt;0.01）.The indexes of health were respectively 0.78 and 1 in the tape group and the statlock group the eighth week after PICC , and the difference was statistically significant （χ2 =52.746, P＆lt;0.01）.Conclusions The score of pain in the tape group is better than that in the statlock group;however, the mental status and life quality of patients in the statlock group are better than those in the tape group .