护理干预对中心静脉导管置管后静脉炎的控制效果评价

Effect assessment by nursing intervention to prevent phlebitis for patients

目的对肝移植患者的经外周静脉穿刺置入中心静脉导管(PICC)置管进行综合护理干预,有效降低静脉炎的发生率。方法调查医院2011年1月-2012年7月进行PICC置管的患者共411例,以2011年11月1日PICC置管的患者采用综合护理措施前后为界,随机分为对照组和干预组;对照组229例采用传统置管方法,干预组182例通过置管前、中、后干预护理及指导患者正确进行自我维护等综合护理干预措施预防静脉炎的发生。结果对照组229例PICC置管后患者发生静脉炎39例发生率为17.03%,干预组182例患者发生静脉炎15例发生率为8.24%,经χ2检验,两组间差异有统计学意义(χ2=6.86,P<0.01)。结论对肝移植患者PICC置管前后给予综合护理干预措施,可有效降低PICC置管后静脉炎的发生率,取得很好的临床效果。

OBJECTIVE Comprehensive nursing intervention of PICC for patients of liver transplantation can effectively reduce the incidence of phlebitis and increase the time of PICC indwelling. METHODS Nov. 1, 2011 was bounded, and since that day comprehensive nursing method was implemented for patients with PICC. The 411 patients with PICC between Jan. 2011 and Jul. 2011 in our hospital were divided into control group and intervention group according to the boundary; the control group including 229 cases used conventional catheter method, while the intervention group including 182 cases were adopted by postoperative comprehensive nursing intervention such as fully prepared before PICC, correct operation in PICC, nursing intervention after PICC and guiding patients to maintain their selves so as to prevent the occurrence of phlebitis. RESULTS The phlebitis occured in 39 cases among the 229 cases of the control group after PICC, and the incidence was 17.03%, while the phlebitis occured in 15 cases among the 182 cases of the intervention group after PICC, the incidence was 8.24%. By the chi square test, it showed that there was significant between the two groups （χ2 =6. 86, P〈0. 01）. CONCLUSION Comprehensive nursing intervention for patients of liver transplantation before and after PICC can effectively reduce the incidence of phlebitis and achieved better clinical outcome.