集束化护理在结直肠癌PICC置管患者中的应用效果

Effects of bundle care on colorectal cancer patients receiving peripherally inserted central catheter

目的 探讨集束化护理在结直肠癌PICC置管患者中的应用效果。 方法 采用方便抽样法,选取2016年1月—2017年12月衢州市第三医院进行PICC置管的结直肠癌患者为研究对象。其中2016年1—12月置管的患者90例为对照组,给予常规护理;2017年1—12月置管的患者90例为观察组,给予集束化护理。收集两组患者临床资料,采用肿瘤患者PICC自我管理能力量表评估患者PICC自我管理能力,心理弹性量表评估患者心理弹性,生活质量核心量表评估患者生活质量。 结果 干预前,两组患者PICC自我管理能力评分、心理弹性评分、功能领域评分、症状领域评分、单项领域评分、整体健康/生活质量评分比较差异无统计学意义(P>0.05);干预后,观察组患者PICC自我管理能力评分、心理弹性评分、功能领域评分、整体健康/生活质量评分高于对照组,症状领域评分、单项领域评分低于对照组,差异均有统计学意义(P<0.05)。干预后,观察组患者静脉炎、导管相关性感染、穿刺点渗血、药物外渗、导管堵塞的发生率及静脉血栓的发生率均低于对照组,差异均有统计学意义(P<0.05)。 结论 集束化护理在结直肠癌患者PICC置管中的应用效果显著,可提高患者PICC自我管理能力、心理弹性和生活质量,降低导管相关不良反应及并发症的发生率,降低静脉血栓的发生率。

Objective To explore the effects of bundle care on colorectal cancer patients receiving peripherally inserted central catheter (PICC) .Methods Colorectal patients who received PICC in Quzhou Third Hospital between January 2016 and December 2017 were selected by convenient sampling. Totally 90 patients receiving PICC between January and December 2016 were divided into the control group which received conventional nursing cate, while another 90 patients receiving PICC between January and December 2017 were divided into the observation group which received bundle care. The patients' clinical data were collected. The PICC Self-Management Capacity Scale, Connor-Davidson Resilience Scale and Quality of life Questionnaire-Core 30 were used to evaluate the patients' PICC self-management capacity, psychological elasticity and quality of life. Results There was no statistical difference in the total scores of PICC self-management capacity, psychological resilience and overall health/quality of life or in any single dimension of function or symptom between the two groups before the intervention (P>0.05);After intervention, the scores of PICC self-management capacity, psychological resilience, functional domain, overall health/quality of life of patients in the observation group were higher than those in the control group, while the symptom domain score and single domain score were lower than those in the control group, with statistical significances (P<0.05) . The incidence rate of phlebitis, catheter-related infection, oozing of puncture point, drug extravasation, catheter obstruction and venous thrombosis in the observation group were lower than that in the control group after the intervention (P<0.05) .Conclusions Bundle care show significant effects on colorectal cancer patients receiving PICC, which can improve patients' PICC self-management capacity, psychological elasticity and quality of life and reduce the incidence rate of catheter-related adverse effects, complications and venous thrombosis.