透明贴联合藻酸盐银预防PICC置管穿刺部位感染的临床研究

Clinic study on transparent stickers combined with alginate in the prevention of infections of PICC catheter insertion sites

目的探讨透明贴联合藻酸盐银预防肺癌患者行经外周静脉穿刺中心静脉(PICC)置管穿刺部位局部感染发生情况,为PICC置管的肺癌患者寻找良好的固定方法。方法选取2011年4月-2013年12月诊断为肺癌且行PICC穿刺的129例患者为研究对象,采用随机数字法将其随机分为对照组64例和观察组65例,对照组患者在穿刺成功后使用纱布覆盖穿刺点,并以3M贴膜进行固定;观察组患者使用藻酸盐银离子覆盖后以透明贴固定。结果观察组患者未发生感染,对照组患者有6例发生感染,感染率为9.38%,两组比较差异有统计学意义(P<0.05);两组患者渗血发生率比较,差异无统计学意义,观察组患者自感舒适、过敏、非计划性拔管发生率92.31%、3.08%和0,明显优于对照组的54.69%、14.06%和4.69%,差异有统计学意义(P<0.05)。结论通过透明贴联合藻酸盐银预防肺癌PICC导管穿刺部位局部感染确实有效,而且还能提高患者的舒适度、减少皮肤敏感等不良反应发生,在临床具有重要的意义。

OBJECTIVE To investigate the transparent stickers combined with alginate in the prevention of infections on PICC catheter puncture sites in patients with lung cancer so as to find effective fixing methods for them .METHODS Totally 129 cases of patients who were diagnosed as lung cancer and received PICC puncture from Apr .2011 to Dec .2013 were chosen as study objects .They were randomly divided into control group with 64 cases and observation group with 65 cases according to random digits .The patients in the control group used gauze to cover the puncture point and 3M dressing to fix them .After covering with alginate ,the observation group was fixed with transparent dressing .RESULTS The patients in the observation group were not infected while 6 cases in the control group were infected with the rate of 9 .38% .The differences were significant （P〈0 .05） .The blood exudation was of no significance .The rates that patients in observation group felt comfortable and the allergy and tube drawing accidently were 92 .31% ,3 .08% and 0 ,which were obviously superior to the control group with 54 .69% ,14 .06% and 4 .69% （P〈0 .05） .CONCLUSION Transparent stickers combined with alginate are efficient in preventing local infections on PICC catheter puncture sites and can improve the comfortable sensation ,reduce the adverse reactions such as skin sensibility ;hence has great significance in clinic .