结肠癌患者PICC置管连接便携式化疗泵持续泵入化疗的护理体会

Nursing experience of patients with colon cancer PICC catheter connected portable chemotherapy pump continuous infusion chemotherapy

目的总结PICC连接全自动化疗泵持续泵入氟尿嘧啶治疗结肠癌患者的护理体会,推广其在临床中的应用。方法选取肿瘤化疗内科2009年1月—2014年4月71例结肠癌患者,选用爱朋便携式全自动输注泵,采用FOLFOX6方案,应用PICC置管连接便携式化疗泵持续泵入5-氟尿嘧啶化疗,71例患者均按个体计算抗癌药物用量,统一遵医嘱准确配置,持续静脉泵入48 h,21～28 d为一周期,观察并记录结肠癌患者的PICC置管、化疗泵、心理及化疗不良反应。结果 71例结肠癌患者中发生静脉炎3例,占4.2%,表现为穿刺点区红斑;PICC管道堵塞1例,占1.4%,表现为输液减慢,抽回血及冲管阻力增大;胶布过敏3例,占4.2%,表现胶布区红肿、瘙痒;输液泵管道堵塞5例,占7%,表现为泵显示堵塞并报警;胃肠道反应5例,占7%,表现为恶心及呕吐,上述患者经对症护理后,均顺利完成化疗,取得了满意的效果。结论 PICC置管连接便携式化疗泵持续化疗安全、方便,出现的不良反应少,减轻了患者的痛苦,提高了患者的生活质量,并达到了规范治疗的效果。

Objective To summarize the nursing experience of using the peripherally inserted central catheter（ PICC）connected automatic pump continuous infusion of fluorouracil in treatment of colon cancer and promote its application in clinical practice. Methods From Jan. 2009 to Apr. 2014,71 patients of colon cancer received application of PICC catheter connected a portable chemotherapy pump injection 5-fluorouracil,the amount of anti-cancer drugs was calculated according to the individual and continuous intravenous infusion for 48 h for every 21- 28 days. The chemotherapy pump,psychological and adverse reaction of chemotherapy were observed and recorded. Results Phlebitis occurred in 3 cases（ 4. 2%）,with erythema in area of puncture. PICC blocked in 1 case,with slow infusion,resistance of blood return and catheter flushing increasing. Tape allergy occurred in 3 cases（ 4. 2%）,with red,itching in tape area. Infusion pump pipe blocked in 5 cases（ 7%）,with pump blocked and alarm. Gastrointestinal reaction occurred in 5 cases（ 7%）,with nausea and vomiting. After supporting nursing treatment,all patients achieved success in the chemotherapeutic. Conclusion PICC catheter connected portable chemotherapy pump infusion chemotherapy was safe,convenient,with less adverse reactions. It improved the life quality of patients,and reached the standard treatment effect.