重庆地区PICC导管相关性静脉血栓预防护理现状调查

A survey of prevention of PICC-related thrombosis in Chongqing

目的了解重庆地区PICC导管相关性静脉血栓预防护理现状。方法采用自行设计的问卷对重庆地区开展PICC技术的20所医院共39个病区进行调查。结果 PICC导管相关性静脉血栓发生率为0.84%;29个病区在床旁完成PICC穿刺操作,仅10个病区配备有专门的PICC操作室;35个病区的PICC置管由有资质的PICC专科护士实施,但16个病区PICC的维护护士未经过专科知识技能培训。所有病区未采用相关量表进行术前静脉血栓风险评估;仅有8个病区在术前进行了患者体重指数的评估,13个病区未进行术中或术后导管尖端定位;对异位导管处理、肢体活动指导方面也不尽相同。结论重庆地区护理人员在PICC导管相关性静脉血栓预防方面意识有待加强,应从术前综合评估、术后维护上加强培训,建立标准化的预防流程,减少其发生率,延长导管留置时间。

Objective To investigate prevention of PICC-related thrombosis in Chongqing.Methods A total of 39 wards of 20 hospitals carrying out PICC service in Chongqing were surveyed by a self-made questionnaire.Results The incidence of PICC-related venous thrombosis was 0.84％.Besides,29 wards conducted bedside PICC placement on,while only 10 had specific rooms for it.What＇s more,in 35 wards,the insertion was conducted by qualified PICC nurses,while the maintanence in 16 wards was finished by nurses without special training.In addition,none scale was used to assess the thrombembolism risk for patients before insertion,with the BMI （Body Mass Index） was assessed in only 8 （20.51％） wards before insertion,and the catheter tip positioning wasn＇t confirmed in 13 （33.33％） wards either during or after insertion.In addition,the treatment of ectopic catheter and the guidance of physical activity were also different.Conclusion The prevention of PICC-related thrombosis in Chongqing should be strengthened in preoperative comprehensive assessment and postoperative maintenance.Besides,standardized prophylaxis procedure should be established to reduce the incidence of PICC-related thrombosis and to extend the duration of catheter.