改良病号服在普外科腹部手术后留置颈内中心静脉导管患者中的应用

Application of the improved hospital gown with catheter fixer in fixing central venous catheter

目的：探讨改良后的病号服在普外科腹部手术后留置颈内中心静脉导管患者中的应用效果。方法选择普通外科腹部手术后留置颈内中心静脉导管的患者121例，按手术单双日分成观察组62例和对照组59例。观察组在术后给予穿着带有导管固定装置的改良病号服固定导管。对照组患者按常规胶布粘贴方法固定导管。比较两组患者颈内中心静脉导管的固定效果。结果观察组患者平均液体通.时长、平均导管移位时长、导管再固定平均时长、导管发生牵拉平均时长以及平均贴膜完好时长等均大于对照组，差异有统计学意义（t值分别为3．01，3．25，6．13，4．57，9．85；P＜0．05）。固定方法接受程度比较中，观察组患者在活动方便程度和舒适度方面均优于对照组，差异有统计学意义（Z值分别为-9．38，-10．62；P ＜0．01）。观察组患者的导管感染率为4．8％，脱管率为0．0％，均低于对照组（10.1％，3．4％），差异有统计学意义（χ^2值分别为4．93，5．62；P＜0．05）。结论带有导管固定器的改良病号服在颈内静脉置管患者中的应用效果良好，导管固定牢固，导管感染率和脱管率低，患者穿着舒适，活动方便，减少护士工作量，可在临床应用。

Objective To explore the effect of improved hospital gown on fixing central venous catheter.Methods One hundred and twenty-one patients with internal jugular central venous catheter after abdominal surgery from April 2013 to October 2013 were chosen and divided into the observation group and the control group according to the date of operation .The observation group received the hospital gown with catheter fixer so as to fix central venous catheter , and the control group received the routine fixation method through the adhesive plaster .The fixation effect was compared between two groups .Results The average time of liquid smooth, catheter displacement , fixation catheter once again , catheter traction and film intact in the observation group were longer than those in the control group , and the differences were statistically significant （ t=3.01, 3.25,6.13,4.57,9.85, respectively;P〈0.05）.The patients’ comfortable and convenience in activity in the observation group were better than those in the control group , and the differences were statistically significant （Z=-9.38,-10.62, respectively;P〈0.01）.The rates of catheter infection and extubation were respectively 4.8%and 0.0%in the observation group, and were lower than 10.1%and 3.4%in the control group, and the differences were statistically significant （χ^2 =4.93,5.62, respectively;P〈0.05）.Conclusions The improved hospital gown with catheter fixer can fix the internal jugular central venous catheter well , reduce the rates of catheter infection and extubation , increase patients ’ comfortable and convenience in activity , and reduce the workload of nurses , it is worthy of clinical application .