化疗间歇期患者主动终止留置PICC的调查与分析

The investigation and analysis of oncology patients' request to terminate PICC during chemotherapy intervals

目的:描述肿瘤患者化疗间歇期主动终止留置PICC的发生现况,分析其原因并探讨相应对策。方法:采用自制PICC拔管登记表对2014年5-10月北京市某三级甲等医院肿瘤科PICC置管的患者进行登记。结果:共收集381例有效记录,其中化疗间歇期不愿携带PICC的62例(16.27%)。Logistic回归分析发现,患者居住地、在职情况、文化程度及PICC类型是患者间歇期主动终止留置导管的影响因素。结论:患者居住偏远、带管工作、文化程度低及选择A类型(材质为聚氨酯)的导管是间歇期主动终止留置导管的危险因素。因此应针对性地开展健康教育;注重PICC患者的心理护理;加强基层护理人员PICC培训,促进连续性护理服务开展,将有助于提高PICC导管的利用率,降低化疗间歇期主动终止留置PICC的发生率,提升护理质量。

Objective：To describe the current status of voluntary termination of PICC during chemotherapy intervals and to analyze the causes and explore the interventions. Method：The clinical data of oncology patients with PICC from a Level three local cancer hospital in Beijing were recorded during the period of May 2014 to October 2014. Results：381 qualiifed oncology patients were collected, 62 patients requested to terminate PICC （16.27%）. Logistic regression analysis showed that residence, working conditions, education level and PICC type were the inlfuencing factors for termination of PICC. Conclusion：Distant residence, job situation, poor education level and type A PICC tubing were the risk factors for oncology patients to request to terminate PICC. It is suggested to promote speciifc helath education, psychological care, PICC training for nurses, and continuous nursing care in order to increase the application of PICC, decrease the incidence of PICC termination and ultimately improve quality of care.