周林频谱仪照射预防PICC致机械性静脉炎临床护理研究

Clinical Nursing study on the prevention of mechanical phlebitis induced by PICC using Zhou Lin Pu-frequency irradiation

目的：探讨周林频谱仪照射预防PICC致机械性静脉炎发生的疗效,以期降低留置PICC管患者机械性静脉炎的发生率,为患者提供安全有效的PICC置管临床护理方案,延长PICC管使用期及增加患者舒适度。方法：将164例PICC置管患者随机分成对照组82例,试验组82例。对照组：PICC置管后常规护理,置管后给予外帖IV3000透明护肤膜,24 h更换敷料后每周更换或敷料随松随脏随时更换,输液期间、输液完后用0.9%NaCl 20 ml脉冲式冲管,用含50 u/ml肝素钠盐水封管,非输液期间每周冲管、封管及更换肝素帽接头一次。试验组：PICC置管后常规护理同对照组,不同的是在置管后30 min裸露照射部位,即术肢穿刺点至肩峰的管道走向部位,给予周林频谱仪照射,高度大约20~40 cm,温度以患者感觉皮肤温热、舒适为宜,每次照射20~30 min,2次/d,连照三天。结果：82例置管患者发生Ⅰ级机械性静脉炎4例。对照组：82例置管患者发生Ⅰ级机械性静脉炎11例、Ⅱ级机械性静脉炎3例、Ⅲ级机械性静脉炎2例。结论：PICC置管后在常规护理基础上增加周林频谱仪照射穿刺点至肩峰的管道走向部位,可有效预防PICC致机械性静脉炎,显著降低了PICC置管患者机械性静脉炎的发生率。

Objective To reduce the rate of mechanical phlebitis of patients with the peripheral Inserted Central Catheters （PICC） ,provide a safe and effective clinical care program for the patients with PICC,extend the use period of PICC and increase patient comfort,we studied the affection of Zhou Lin spectrum analyzer irradiation on preventing the development of mechanical phlebitis induced by PICC.Method 164 patients with PICC were randomly divided into the experimental group （82 cases） and control group （82 cases） .Routine care was given and IV3000 transparent film was posted outside for control group after inserting a PICC into the venae superficiales membri superioris.Transparent film was replaced after 24 hours and replaced once for a week or replaced when dressing or dressing dirty with loose change at any time.A 20 ml of 0.9% saline solution was pulsed the red tube during and following infusion.Heparin saline with50 u/ml was used to seal tube.Red tube and heparin saline sealed tube and heparin cap changed were done once for a week.Routine care was also provided for the experimental groups.Besides,the part of PICC （from the puncture to shoulder） of the experimental groups was irradiated by the Zhou Lin spectrum analyzer over 20-40 cm of the PICC for 20-30 minutes.The irradiation was performed twice a day for three days.The patients with irradiation felt the skin temperature to be warm and comfortable.Results Four cases with gradeⅠcatheter mechanical phlebitis happened for the experimental group.GradeⅠ、Ⅱ and Ⅲ catheter mechanical phlebitis happened in 11、3 and 2 cases of control group.Conclusion Zhou Lin spectrum analyzer irradiation following routine care can effectively prevent the mechanical phlebitis induced by PICC,significantly reducing the rate of mechanical phlebitis of patients with PICC.